Unknown Individual – Nephrology Physician, NPI 1811963069

Unknown Individual is a healthcare provider. based in Plantation, Florida. specializing in Nephrology Physician. They hold a License No. ME23299 (FL). The NPI Number for Unknown Individual is 1811963069

Main info

Organization
Inactive
58 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1811963069
Phone
(954) 791-6622
Address
7050 NW 4TH ST
Deactivation Date
18 February 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1968 (58 years ago)
PAC ID
7517126386
Professional Enrollment ID
I20120314000441
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

  • 7050, Northwest 4th Street, Plantation Gardens, Plantation, Broward County, Florida, 33317, United States

    SUITE # 206

    PLANTATION, FL 333172247

    Phone: (954) 791-6622

    Fax: (954) 791-9215

    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 9 Open Payments records for all available years, with a total value of $138.

Total Amount is formed as General ($138) + Research ($0) + Ownership ($0) = $138.

Last reported payment date: 2024-07-17 • Largest payer in this snapshot: Lilly USA, LLC ($85).

Total Amount

$138

General + Research + Ownership

Payments

9

Total payment records

General Amount

$138

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-07-17

Latest reported date

Top Companies

Largest payers in this snapshot

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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.

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

Insurance plans in this area (ZIP 33317)

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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 1811963069.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual's primary classification?
Nephrology Physician is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Plantation, Florida; more addresses can appear in NPPES.
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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