Unknown Individual – Emergency Medicine Physician, NPI 1740233881

Unknown Individual is a healthcare provider. based in Palm coast, Florida. specializing in Emergency Medicine Physician. They hold a License No. ME56579 (FL). The NPI Number for Unknown Individual is 1740233881

Main info

Organization
Inactive
45 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1740233881
Phone
(386) 586-2000
Address
60 MEMORIAL MEDICAL PKWY
Deactivation Date
23 August 2021

Doctor Profile

Medical School Name
SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
2174435221
Graduation Year
1981 (45 years ago)
PAC ID
6204738628
Group Practice PAC ID
0244395739
Professional Enrollment ID
I20040124000304
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

  • Florida Hospital Flagler, 60, Memorial Medical Parkway, Palm Coast, Flagler County, Florida, 32164, United States

    PALM COAST, FL 321645980

    Phone: (386) 586-2000

    Type: Location

  • 3050, Elaine Court, Flossmoor, Rich Township, Cook County, Illinois, 60422, United States

    FLOSSMOOR, IL 604221462

    Phone:

    Type: Mailing

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.

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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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32164)

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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: 0244395739View full group profile

Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1740233881 as the unique 10-digit identifier.
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 Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Palm Coast, Florida as the reference point for Unknown Individual, then confirm.
Does Unknown Individual accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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