Unknown Individual – Family Medicine Physician, NPI 1902875651

Unknown Individual is a healthcare provider. based in Jupiter, Florida. specializing in Family Medicine Physician. They hold a License No. L6262 (TX). The NPI Number for Unknown Individual is 1902875651

Main info

Organization
Inactive
32 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1902875651
Phone
(561) 744-7263
Address
1004 S OLD DIXIE HWY
Deactivation Date
8 February 2023

Doctor Profile

Medical School Name
MEHARRY MEDICAL COLLEGE SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
1994 (32 years ago)
PAC ID
8123932522
Professional Enrollment ID
I20060317000323
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 1004, South Old Dixie Highway, Jupiter, Palm Beach County, Florida, 33458, United States

    STE. 303

    JUPITER, FL 334587200

    Phone: (561) 744-7263

    Type: Location

  • 115, Seagrape Drive, Jupiter, Palm Beach County, Florida, 33458, United States

    STE 201

    JUPITER, FL 334587831

    Phone: (561) 744-7263

    Fax: (561) 744-7263

    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.

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 33458)

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Provider's Procedures

Unknown Individual performs procedures in Family Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINEFL71010X-ray of chest, 1 view, front6764
FAMILY MEDICINEFL93010Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report157146

Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1902875651 on file in the registry.
Is Unknown Individual still active if the NPI shows inactive?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Family Medicine Physician in the directory — Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Jupiter?
Public fields place Unknown Individual around Jupiter, Florida. Always confirm the exact site before visiting.
Can I trust this NPI listing for Unknown Individual?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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