Unknown Individual – Pulmonary Disease Physician, NPI 1629042494

Unknown Individual is a healthcare provider. based in Crystal river, Florida. specializing in Pulmonary Disease Physician. They hold a License No. ME0040661 (FL). The NPI Number for Unknown Individual is 1629042494

Main info

Organization
Inactive
51 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1629042494
Phone
(352) 795-1999
Address
5616 W NORVELL BRYANT HWY
Deactivation Date
30 August 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3527951999
Graduation Year
1975 (51 years ago)
PAC ID
9638101892
Group Practice PAC ID
2466484621
Professional Enrollment ID
I20100809000714
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

  • Tampa General Hospital Crystal River Emergency Center, 907, West Norvell Bryant Highway, Hernando, Citrus County, Florida, 34442, United States

    CRYSTAL RIVER, FL 344297572

    Phone: (352) 795-1999

    Fax: (352) 795-2269

    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)

CMS reports 4 Open Payments records for all available years, with a total value of $168.

Total Amount is formed as General ($168) + Research ($0) + Ownership ($0) = $168.

Last reported payment date: 2024-04-08 • Largest payer in this snapshot: Pulmonx Corporation ($144).

Total Amount

$168

General + Research + Ownership

Payments

4

Total payment records

General Amount

$168

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-04-08

Latest reported date

Top Companies

Largest payers in this snapshot

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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 34429)

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Provider's Procedures

Unknown Individual performs procedures in Pulmonary Disease Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PULMONARY DISEASEFL94060Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration5454
PULMONARY DISEASEFL94727Determination of lung volumes using gas dilution or washout7171

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: 2466484621View full group profile
NameSpecialtyState
Pulmonary DiseaseFL
Pulmonary Disease, Internal Medicine, Critical Care (Intensivists)FL
Pulmonary Disease, Critical Care (Intensivists), Internal Medicine, Sleep MedicineFL
Internal Medicine, Critical Care (Intensivists), Pulmonary DiseaseFL
Internal Medicine, Critical Care (Intensivists), Pulmonary DiseaseFL

Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1629042494 when you need to reference Unknown Individual in forms, claims, or directories.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Pulmonary Disease Physician. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Crystal River, Florida because that is what the record indicates for Unknown Individual.
What if Crystal River, Florida seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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