Unknown Individual – Internal Medicine Physician, NPI 1669496188

Unknown Individual is a healthcare provider. based in Eustis, Florida. specializing in Internal Medicine Physician. They hold a License No. ME47796 (FL). The NPI Number for Unknown Individual is 1669496188

Main info

Organization
Inactive
44 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1669496188
Phone
(352) 589-4774
Address
2101 PREVATT ST
Deactivation Date
21 February 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1982 (44 years ago)
PAC ID
7719053222
Professional Enrollment ID
I20080908000289
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

  • 2101, Prevatt Street, Mount Homer, Eustis, Lake County, Florida, 32627, United States

    EUSTIS, FL 327266131

    Phone: (352) 589-4774

    Fax: (352) 589-5092

    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 6 Open Payments records for all available years, with a total value of $503.

Total Amount is formed as General ($503) + Research ($0) + Ownership ($0) = $503.

Last reported payment date: 2023-11-02 • Largest payer in this snapshot: Novo Nordisk Inc ($251).

Total Amount

$503

General + Research + Ownership

Payments

6

Total payment records

General Amount

$503

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-11-02

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
99214Established patient office or other outpatient visit, 30-39 minutes1,995688$0
36415Insertion of needle into vein for collection of blood sample1,135493$0
G0444Annual depression screening, 5 to 15 minutes556556$0
99212Established patient office or other outpatient visit, 10-19 minutes534313$0
99213Established patient office or other outpatient visit, 20-29 minutes527311$0
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Insurance plans in this area (ZIP 32726)

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Provider's Procedures

Unknown Individual performs procedures in Internal Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
INTERNAL MEDICINEFL81002Urinalysis, manual test172118
INTERNAL MEDICINEFL85610Blood test, clotting time34138
INTERNAL MEDICINEFL90670Pneumococcal vaccine for injection into muscle9696

Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1669496188 for Unknown Individual, then check state licensing separately.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Eustis, Florida as a primary anchor for Unknown Individual unless the record lists multiple sites.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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