Unknown Individual – Colon & Rectal Surgery Physician, NPI 1922063882

Unknown Individual is a healthcare provider. based in Miami, Florida. specializing in Colon & Rectal Surgery Physician. They hold a License No. ME85645 (FL). The NPI Number for Unknown Individual is 1922063882

Main info

Organization
Inactive
38 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1922063882
Phone
(305) 585-1288
Address
1611 NW 12TH AVE
Deactivation Date
30 August 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3052434211
Graduation Year
1988 (38 years ago)
PAC ID
0143417873
Group Practice PAC ID
3274795109
Professional Enrollment ID
I20101207001281
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

  • Jackson Memorial Hospital, 1611, Northwest 12th Avenue, Miami, Miami-Dade County, Florida, 33136, United States

    BOX 016960 M851

    MIAMI, FL 331361005

    Phone: (305) 585-1288

    Fax: (305) 243-8470

    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 5 Open Payments records for all available years, with a total value of $397.

Total Amount is formed as General ($397) + Research ($0) + Ownership ($0) = $397.

Last reported payment date: 2024-03-12 • Largest payer in this snapshot: Innovation Technologies Inc ($223).

Total Amount

$397

General + Research + Ownership

Payments

5

Total payment records

General Amount

$397

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-03-12

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 minutes5747$0
99213Established patient office or other outpatient visit, 20-29 minutes3432$0
45380Biopsy of large bowel using a flexible endoscope1716$0
99203New patient office or other outpatient visit, 30-44 minutes1717$0
99204New patient office or other outpatient visit, 45-59 minutes1515$0
View full utilization report →

Insurance plans in this area (ZIP 33136)

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Provider's Procedures

Unknown Individual performs procedures in Colon & Rectal Surgery Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
GENERAL SURGERYFL45378Diagnostic examination of large bowel using an endoscope1717
GENERAL SURGERYFL45385Removal of polyps or growths of large bowel using an endoscope1818

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: 3274795109View full group profile
NameSpecialtyState
O P H T H A L M O L O G YFL
-FL
O P H T H A L M O L O G YFL

Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1922063882?
NPI 1922063882 belongs to Unknown Individual; compare other details if you need extra assurance.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Colon & Rectal Surgery Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Miami, Florida.
Does Unknown Individual accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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