Unknown Individual – Psychiatry Physician, NPI 1912963380

Unknown Individual is a healthcare provider. based in Satellite beach, Florida. specializing in Psychiatry Physician. They hold a License No. ME-0050534 (FL). The NPI Number for Unknown Individual is 1912963380

Main info

Organization
Inactive
49 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1912963380
Phone
(321) 779-9838
Address
1275 S PATRICK DR
Deactivation Date
10 April 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3217799838
Graduation Year
1977 (49 years ago)
PAC ID
8921124447
Group Practice PAC ID
0042403610
Professional Enrollment ID
I20100921001535
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

  • South Patrick Drive, Satellite Beach, Brevard County, Florida, 32937, United States

    SUITE C

    SATELLITE BEACH, FL 329373963

    Phone: (321) 779-9838

    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 2 Open Payments records for all available years, with a total value of $51.

Total Amount is formed as General ($51) + Research ($0) + Ownership ($0) = $51.

Last reported payment date: 2023-09-20 • Largest payer in this snapshot: Teva Pharmaceuticals USA, Inc. ($29).

Total Amount

$51

General + Research + Ownership

Payments

2

Total payment records

General Amount

$51

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-09-20

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 minutes677153$0
90833Psychotherapy with evaluation and management visit, 30 minutes3016$0
90792Psychiatric diagnostic evaluation with medical services2417$0
View full utilization report →

Insurance plans in this area (ZIP 32937)

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Provider's Procedures

Unknown Individual performs procedures in Psychiatry Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PSYCHIATRYFL90833Psychotherapy, 30 minutes with patient and/or family member5239

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: 0042403610View full group profile
NameSpecialtyState
Mental Health CounselorFL
Mental Health CounselorFL
Pediatric Medicine, PsychiatryFL
Nurse PractitionerFL
Nurse PractitionerFL
Clinical Social WorkerFL
Clinical Social WorkerFL
Clinical Social WorkerFL
Mental Health CounselorFL
Nurse PractitionerFL

Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1912963380 for Unknown Individual.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
How should patients interpret Unknown Individual's specialty?
The extract shows Psychiatry Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Satellite Beach, Florida?
For routing, start with Satellite Beach, Florida for Unknown Individual, then verify phone and hours locally.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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