Unknown Individual – Family Medicine Physician, NPI 1609872019

Unknown Individual is a healthcare provider. based in Vero beach, Florida. specializing in Family Medicine Physician. They hold a License No. ME0033013 (FL). The NPI Number for Unknown Individual is 1609872019

Main info

Organization
Inactive
49 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1609872019
Phone
(772) 567-6340
Address
1265 36TH ST
Deactivation Date
9 September 2021

Doctor Profile

Medical School Name
MEDICAL COLLEGE OF PENNSYLVANIA
Secondary Phone
7725676340
Graduation Year
1977 (49 years ago)
PAC ID
4385779172
Group Practice PAC ID
0749275931
Professional Enrollment ID
I20100318000423
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 1265, 36th Street, Gifford, Indian River County, Florida, 32960, United States

    VERO BEACH, FL 329606574

    Phone: (772) 567-6340

    Fax: (772) 567-3564

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32960)

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Provider's Procedures

Unknown Individual performs procedures in Family Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINEFL20610Aspiration and/or injection of large joint or joint capsule5733
FAMILY MEDICINEFL90670Pneumococcal vaccine for injection into muscle4040
FAMILY MEDICINEFL93010Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report1815
FAMILY MEDICINEFL94060Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration2814

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0749275931View full group profile

Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1609872019 — the number used across U.S. healthcare to identify this provider.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Vero Beach, Florida.
Can I trust this NPI listing for Unknown Individual?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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