Unknown Individual – Internal Medicine Physician, NPI 1942279005
Internal Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
Pensacola Avenue, Caversham, Perth, Western Australia, 6055, Australia
PENSACOLA, FL 325132699
Phone:
Type: Mailing
West Redstone Avenue, Crestview, Okaloosa County, Florida, 32536, United States
SUITE 200
CRESTVIEW, FL 325366430
Phone: (850) 682-6122
Fax: (850) 682-5917
Type: Location
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 $40.
Total Amount is formed as General ($40) + Research ($0) + Ownership ($0) = $40.
Last reported payment date: 2024-04-16 • Largest payer in this snapshot: Novo Nordisk Inc ($40).
Total Amount
$40
General + Research + Ownership
Payments
2
Total payment records
General Amount
$40
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-04-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Novo Nordisk Inc | $40 |
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 32513)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| INTERNAL MEDICINE | FL | 93010 | Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report | 35 | 33 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | FL | |
| - | FL | |
| Nurse Practitioner | FL | |
| - | FL | |
| - | FL | |
| Nephrology, Internal Medicine | FL | |
| Interventional Cardiology | AL | |
| Nurse Practitioner | FL | |
| Physician Assistant | FL | |
| Orthopedic Surgery | FL |
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