Unknown Individual – Podiatrist, NPI 1861463002

Unknown Individual is a healthcare provider. based in Fort myers, Florida. specializing in Podiatrist. They hold a License No. PO0001693 (FL). The NPI Number for Unknown Individual is 1861463002

Main info

Organization
Inactive
41 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1861463002
Phone
(239) 936-5400
Address
5238 MASON CORBIN CT
Deactivation Date
14 January 2021

Doctor Profile

Medical School Name
KENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE
Secondary Phone
2399365400
Graduation Year
1985 (41 years ago)
PAC ID
3476697673
Group Practice PAC ID
1951329986
Professional Enrollment ID
I20100225000149
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

  • 5238, Mason Corbin Court, Fort Myers, Lee County, Florida, 33907, United States

    SUITE 102

    FORT MYERS, FL 339077738

    Phone: (239) 936-5400

    Fax: (239) 936-9572

    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 33907)

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Provider's Procedures

Unknown Individual performs procedures in Podiatrist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PODIATRYFL11720Removal of tissue from 1 to 5 finger or toe nails1313

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: 1951329986View full group profile
NameSpecialtyState
DR. MICHAEL JAMES WILKINS (DPM)
P O D I A T R YFL
KRISTA HOWARD (DPM)
P O D I A T R YFL
DR. DAVID SCOTT ANDREW (DPM)
P O D I A T R YFL

Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1861463002.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
How should patients interpret Unknown Individual's specialty?
The extract shows Podiatrist for Unknown Individual. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Fort Myers, Florida?
If you are local to Fort Myers, Florida, Unknown Individual may be relevant to your search.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.