Unknown Individual – Critical Care Medicine (Internal Medicine) Physician, NPI 1629075841

Unknown Individual is a healthcare provider. based in North palm beach, Florida. specializing in Critical Care Medicine (Internal Medicine) Physician. They hold a License No. MD60442141 (WA). The NPI Number for Unknown Individual is 1629075841

Main info

Organization
Inactive
45 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1629075841
Phone
(412) 480-6913
Address
370 GOLFVIEW RD
Deactivation Date
9 March 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8123733025
Graduation Year
1981 (45 years ago)
PAC ID
3779473731
Group Practice PAC ID
1052612314
Professional Enrollment ID
I20151207002600
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:0State licenses:3Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 370, Golfview Road, North Palm Beach, Palm Beach County, Florida, 33408, United States

    #502

    NORTH PALM BEACH, FL 334083557

    Phone: (412) 480-6913

    Type: Mailing

  • 200 NE Mother Joseph Pl

    Vancouver, WA 986643299

    Phone: (360) 514-2990

    Type: Location

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 33408)

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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: 1052612314View full group profile
NameSpecialtyState
-IL
Family PracticeIL
Physician AssistantIN
N E U R O L O G YFL
Nurse PractitionerIN
Nurse PractitionerIL
Family PracticeIN
Family PracticeIN
Physician AssistantIL
Nurse PractitionerIN

Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1629075841.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Critical Care Medicine (Internal Medicine) Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with North Palm Beach, Florida in the same public data insurers reference.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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