Unknown Individual – Adult Reconstructive Orthopaedic Surgery Physician, NPI 1861435505

Adult Reconstructive Orthopaedic Surgery Physician

Unknown Individual is a healthcare provider. based in Clearwater, Florida. specializing in Adult Reconstructive Orthopaedic Surgery Physician. They hold a License No. ME 0026553 (FL). The NPI Number for Unknown Individual is 1861435505

Main info

Organization

Inactive

56 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1861435505

Phone

(727) 461-6026

Address

430 MORTON PLANT ST

Deactivation Date

29 April 2023

Doctor Profile

Medical School Name

PERELMAN SCHOOL OF MED AT THE UNIVERSITY OF PENNSYLVANIA

Secondary Phone

81397897007646

Graduation Year

1970 (56 years ago)

PAC ID

7012040744

Group Practice PAC ID

1052224102

Professional Enrollment ID

I20100802000970

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

Morton Plant Street, Clearwater, Pinellas County, Florida, 33756, United States
SUITE 301
CLEARWATER, FL 337563395
Phone: (727) 461-6026
Fax: (727) 461-7446
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.

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 33756)

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Provider's Procedures

Unknown Individual performs procedures in Adult Reconstructive Orthopaedic Surgery Physician. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
ORTHOPEDIC SURGERY	FL	20610	Aspiration and/or injection of large joint or joint capsule	413	224
ORTHOPEDIC SURGERY	FL	73562	X-ray of knee, 3 views	640	313
ORTHOPEDIC SURGERY	FL	97110	Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes	135	88

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: 1052224102View full group profile

Name	Specialty	State
ANNETTE M FRECHETTE-LYNN (PA)	-	FL
MR. CLINTON BERTRAND II DAVIS (M.D.)	-	FL
LINDSAY ANN LANDRY (PT)	-	FL
RYAN M WADAS (DPT)	-	FL
ADAM PIGNON	-	FL
DR. KURT C. HIRSHORN (M.D.)	Orthopedic Surgery	FL
DONALD RAY REYNOLDS (PT, DPT)	-	FL
STEPHEN R DARCY (PT)	Physical Therapist In Private Practice	FL
KENNETH GUSTKE (MD)	-	FL
JOHN M SMALL (MD)	Orthopedic Surgery	FL

Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1861435505?

NPI 1861435505 belongs to Unknown Individual; compare other details if you need extra assurance.

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 Adult Reconstructive Orthopaedic Surgery Physician. Clinical services aligned with this taxonomy classification.

Where in Florida is Unknown Individual registered?

Use Clearwater, Florida as the headline location for Unknown Individual here.

When was this NPI issued?

Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.