Unknown Individual – Podiatrist, NPI 1689696601

Unknown Individual is a healthcare provider. based in Hallandale beach, Florida. specializing in PODIATRY. They hold a License No. PO745 (FL). The NPI Number for Unknown Individual is 1689696601

Main info

Organization
Inactive
52 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1689696601
Phone
(954) 458-2228
Address
1250 E HALLANDALE BEACH BLVD
Deactivation Date
9 April 2026

Doctor Profile

Medical School Name
NEW YORK COLLEGE OF PODIATRIC MEDICINE
Secondary Phone
-
Graduation Year
1974 (52 years ago)
PAC ID
7416070222
Professional Enrollment ID
I20101206000503
Address ID
FL330094636Ha1250XBLVD501
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

1,444 PODIATRY in FL

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Provider Addresses for Unknown Individual

  • 1250, East Hallandale Beach Boulevard, Golden Isles, Hallandale Beach, Broward County, Florida, 33009, United States

    SUITE 1005A

    HALLANDALE BEACH, FL 330094636

    Phone: (954) 458-2228

    Fax: (954) 458-2530

    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.

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20101206000503IPodiatryFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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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
11721Removal of fingernails or toenails, 6 or more nails736279$0
99213Established patient office or other outpatient visit, 20-29 minutes655308$0
17110Destruction of skin growth, 1-14 growths486229$0
97597Removal of tissue from wound, 20.0 sq cm or less418210$0
11730Simple separation of fingernail or toenail from nail bed, first nail312226$0
View full utilization report →

Insurance plans in this area (ZIP 33009)

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Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1689696601 — the number used across U.S. healthcare to identify this provider.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Podiatrist. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Hallandale Beach, Florida.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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