Unknown Individual – Internal Medicine Physician, NPI 1982609392

Unknown Individual is a healthcare provider. based in Ponte vedra beach, Florida. specializing in Internal Medicine Physician. They hold a License No. ME85431 (FL). The NPI Number for Unknown Individual is 1982609392

Main info

Organization
Inactive
33 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1982609392
Phone
(904) 285-9355
Address
1100 SAWGRASS VILLAGE DR
Deactivation Date
19 April 2023

Doctor Profile

Medical School Name
UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
Secondary Phone
9412418300
Graduation Year
1993 (33 years ago)
PAC ID
0143271783
Group Practice PAC ID
1658347562
Professional Enrollment ID
I20050202000927
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

Provider Addresses for Unknown Individual

  • 1100 SAWGRASS VILLAGE DR

    SUITE 100

    PONTE VEDRA BEACH, FL 320825048

    Phone: (904) 285-9355

    Fax: (904) 285-7442

    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 1 Open Payments records for all available years, with a total value of $19.

Total Amount is formed as General ($19) + Research ($0) + Ownership ($0) = $19.

Last reported payment date: 2023-01-13 • Largest payer in this snapshot: Abbott Laboratories ($19).

Total Amount

$19

General + Research + Ownership

Payments

1

Total payment records

General Amount

$19

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-01-13

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Abbott Laboratories$19
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 minutes6351$0
99497Advance care planning, first 30 minutes3030$0
View full utilization report →

Insurance plans in this area (ZIP 32082)

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Provider's Procedures

Unknown Individual performs procedures in Internal Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
INTERNAL MEDICINEFL94060Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration3737

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: 1658347562View full group profile

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 1982609392.
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 Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Ponte Vedra Beach, Florida may find Unknown Individual in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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