Unknown Individual – Gastroenterology Physician, NPI 1972653632

Unknown Individual is a healthcare provider. based in Cape coral, Florida. specializing in Gastroenterology Physician. They hold a License No. ME 0034362 (FL). The NPI Number for Unknown Individual is 1972653632

Main info

Organization
Inactive
52 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1972653632
Phone
(239) 574-8616
Address
708 DEL PRADO BLVD
Deactivation Date
5 June 2024

Doctor Profile

Medical School Name
UNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Secondary Phone
-
Graduation Year
1974 (52 years ago)
PAC ID
4688850308
Professional Enrollment ID
I20110513000573
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

  • Del Prado Boulevard South, Cape Coral, Lee County, Florida, 33904, United States

    CAPE CORAL, FL 339905616

    Phone: (239) 574-8616

    Fax: (239) 574-4451

    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)

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes550212$0
17000Destruction of precancer skin growth, 1 growth435181$0
17003Destruction of precancer skin growth, 2-14 growths414179$0
99349Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes22916$0
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes4411$0
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Insurance plans in this area (ZIP 33990)

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Provider's Procedures

Unknown Individual performs procedures in Gastroenterology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
INTERNAL MEDICINEFL17003Destruction of 2-14 skin growths2928

Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1972653632.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Gastroenterology Physician. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Cape Coral, Florida may find Unknown Individual in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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