Unknown Individual – Psychiatry Physician, NPI 1922096437

Unknown Individual is a healthcare provider. based in North miami, Florida. specializing in Psychiatry Physician. They hold a License No. ME56209 (FL). The NPI Number for Unknown Individual is 1922096437

Main info

Organization
Inactive
52 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1922096437
Phone
(888) 852-6672
Address
1065 NE 125TH ST
Deactivation Date
18 January 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9549758900
Graduation Year
1974 (52 years ago)
PAC ID
0042118416
Group Practice PAC ID
6204733413
Professional Enrollment ID
I20031222000893
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 1065, Northeast 125th Street, North Miami, Miami-Dade County, Florida, 33161, United States

    SUITE 409

    NORTH MIAMI, FL 331615821

    Phone: (888) 852-6672

    Fax: (305) 891-4228

    Type: Mailing

  • 206, Northeast 125th Street, North Miami, Miami-Dade County, Florida, 33161, United States

    NORTH MIAMI, FL 33161

    Phone: (888) 852-6672

    Fax: (305) 891-4228

    Type: Location

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 33161)

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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: 6204733413View full group profile

Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1922096437 when you need to reference Unknown Individual in forms, claims, or directories.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
What kind of provider is Unknown Individual?
The page reflects Psychiatry Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Florida?
You will see North Miami, Florida on file for Unknown Individual alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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