Unknown Individual – Rheumatology Physician, NPI 1619931334

Rheumatology Physician

Unknown Individual is a healthcare provider. based in Melbourne, Florida. specializing in Rheumatology Physician. They hold a License No. ME50849 (FL). The NPI Number for Unknown Individual is 1619931334

Main info

Organization

Inactive

45 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1619931334

Phone

(321) 541-1777

Address

2222 S HARBOR CITY BLVD

Deactivation Date

31 July 2024

Doctor Profile

Medical School Name

UNIVERSITY CENTRAL DEL CARIBE ESCUELA DE MEDICINA

Secondary Phone

3215411715

Graduation Year

1981 (45 years ago)

PAC ID

9931232725

Group Practice PAC ID

2860688728

Professional Enrollment ID

I20100730000312

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

2222, South Harbor City Boulevard, Downtown Melbourne, Melbourne, Brevard County, Florida, 32901, United States
MELBOURNE, FL 329015594
Phone: (321) 541-1777
Fax: (321) 725-5504
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 32901)

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Provider's Procedures

Unknown Individual performs procedures in Rheumatology Physician. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
RHEUMATOLOGY	FL	20610	Aspiration and/or injection of large joint or joint capsule	157	108

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: 2860688728View full group profile

Name	Specialty	State
MRS. PATRICIA NOREEN FINNERAN (NP-C)	-	MA
HEIDI SUSAN BEE (DO)	-	PA
DR. SHRUTI SATYANARAYAN BIYANI (MD)	O B S T E T R I C S/ G Y N E C O L O G Y	MA
LARAE TYMOCHKO (PA-C)	-	PA
DAVID RANDALL HOFIUS (D.O.)	General Surgery	PA
TONIA L SKAKALSKI (D.O.)	-	PA
JANE G BUTLIN (MD)	-	MA
DR. PEGGY MENTOR (MD)	-	MA
SUSAN E VOGLER (D.O.)	-	MA
ERSAN YALCIN (M.D.)	-	MA