Unknown Individual – Pain Medicine (Anesthesiology) Physician, NPI 1639342785

Unknown Individual is a healthcare provider. based in Odessa, Florida. specializing in Pain Medicine (Anesthesiology) Physician. They hold a License No. 218935 (MA). The NPI Number for Unknown Individual is 1639342785

Main info

Organization
Inactive
27 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1639342785
Phone
(813) 344-9230
Address
12929 ROYAL GEORGE AVE
Deactivation Date
2 October 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1999 (27 years ago)
PAC ID
7113069147
Professional Enrollment ID
I20100128000609

Contacts

Other Endpoint
www.ohmedica.com
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness85
Years active:0State licenses:2Other namesUpdated within 12 months

Provider Addresses for Unknown Individual

  • 12929 ROYAL GEORGE AVE

    ODESSA, FL 335565710

    Phone: (813) 344-9230

    Type: Mailing

  • 400 4TH AVE S APT 1110

    ST PETERSBURG, FL 337014624

    Phone: (813) 344-9230

    Fax: (813) 449-2303

    Type: Location

  • 10903 SHELDON RD

    TAMPA, FL 336264702

    Phone: (727) 631-7846

    Fax: (866) 981-1692

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 24 Open Payments records for all available years, with a total value of $2,660.

Total Amount is formed as General ($2,660) + Research ($0) + Ownership ($0) = $2,660.

Last reported payment date: 2024-07-29 • Largest payer in this snapshot: Saluda Medical Americas, Inc. ($2,294).

Total Amount

$2,660

General + Research + Ownership

Payments

24

Total payment records

General Amount

$2,660

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-07-29

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
J3301Injection, triamcinolone acetonide, not otherwise specified, 10 mg1,303134$0
99214Established patient office or other outpatient visit, 30-39 minutes588172$0
J2001Injection, lidocaine hcl for intravenous infusion, 10 mg44946$0
99204New patient office or other outpatient visit, 45-59 minutes101101$0
Q9962High osmolar contrast material, 300-349 mg/ml iodine concentration, per ml6128$0
View full utilization report →

Insurance plans in this area (ZIP 33556)

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Provider's Procedures

Unknown Individual performs procedures in Pain Medicine (Anesthesiology) Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
ANESTHESIOLOGYFL20610Aspiration and/or injection of large joint or joint capsule1715

Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1639342785.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Pain Medicine (Anesthesiology) Physician. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Odessa, Florida as a primary anchor for Unknown Individual unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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