Unknown Individual – Vascular Surgery Physician, NPI 1780746008

Unknown Individual is a healthcare provider. based in St petersburg, Florida. specializing in Vascular Surgery Physician. They hold a License No. ME126852 (FL). The NPI Number for Unknown Individual is 1780746008

Main info

Organization
Inactive
22 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1780746008
Phone
(727) 998-3467
Address
5880 49TH ST N STE 206
Deactivation Date
12 June 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2004 (22 years ago)
PAC ID
8527381813
Professional Enrollment ID
I20160804002243
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

  • 206, 49th Street North, Live Oak, Saint Petersburg, Pinellas County, Florida, 33710, United States

    ST PETERSBURG, FL 337092147

    Phone: (727) 998-3467

    Type: Location

  • West Waters Avenue, Tampa, Hillsborough County, Florida, 33634, United States

    TAMPA, FL 336141852

    Phone: (813) 348-9088

    Fax: (813) 348-9310

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 31 Open Payments records for all available years, with a total value of $1,765.

Total Amount is formed as General ($1,765) + Research ($0) + Ownership ($0) = $1,765.

Last reported payment date: 2024-02-18 • Largest payer in this snapshot: Medtronic, Inc. ($556).

Total Amount

$1,765

General + Research + Ownership

Payments

31

Total payment records

General Amount

$1,765

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-02-18

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 minutes11179$0
93970Ultrasound study of arm or leg veins with compression and maneuvers6360$0
99204New patient office or other outpatient visit, 45-59 minutes5555$0
93925Ultrasound of leg arteries or artery grafts3430$0
99213Established patient office or other outpatient visit, 20-29 minutes2623$0
View full utilization report →

Insurance plans in this area (ZIP 33709)

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Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1780746008 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 Vascular Surgery Physician. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near St Petersburg, Florida may find Unknown Individual in results; validate coverage separately.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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