Unknown Individual – Family Medicine Physician, NPI 1982686796

Unknown Individual is a healthcare provider. based in Satellite beach, Florida. specializing in Family Medicine Physician. They hold a License No. OS5184 (FL). The NPI Number for Unknown Individual is 1982686796

Main info

Organization
Inactive
48 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1982686796
Phone
(321) 773-2659
Address
1380 S PATRICK DR
Deactivation Date
11 October 2024

Doctor Profile

Medical School Name
MIDWESTERN UNIVERSITY, CHICAGO COLLEGE OF OSTEOPATHIC MED
Secondary Phone
3217732659
Graduation Year
1978 (48 years ago)
PAC ID
8628128626
Group Practice PAC ID
4486558012
Professional Enrollment ID
I20100428000441
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

  • 1380, South Patrick Drive, Satellite Beach, Brevard County, Florida, 32937, United States

    SATELLITE BEACH, FL 329374375

    Phone: (321) 773-2659

    Fax: (321) 773-2667

    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 $16.

Total Amount is formed as General ($16) + Research ($0) + Ownership ($0) = $16.

Last reported payment date: 2024-05-16 • Largest payer in this snapshot: Astellas Pharma US Inc ($16).

Total Amount

$16

General + Research + Ownership

Payments

1

Total payment records

General Amount

$16

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-05-16

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Astellas Pharma US Inc$16
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 minutes15377$0
36415Insertion of needle into vein for collection of blood sample8961$0
99497Advance care planning, first 30 minutes6262$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit6262$0
93880Ultrasound of both sides of head and neck blood flow2828$0
View full utilization report →

Insurance plans in this area (ZIP 32937)

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Provider's Procedures

Unknown Individual performs procedures in Family Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINEFL85610Blood test, clotting time15618

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: 4486558012View full group profile
NameSpecialtyState
Internal Medicine, HospitalistFL
Internal Medicine, Geriatric MedicineFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Internal MedicineFL
Nurse PractitionerFL
Interventional RadiologyFL
Physician AssistantFL
N E U R O L O G YFL

Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1982686796.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Satellite Beach?
Public fields place Unknown Individual around Satellite Beach, Florida. Always confirm the exact site before visiting.
Can I trust this NPI listing for Unknown Individual?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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