Unknown Individual – Trauma Surgery Physician, NPI 1194854091

Unknown Individual is a healthcare provider. based in Augusta, Georgia. specializing in Trauma Surgery Physician. They hold a License No. 77728 (GA). The NPI Number for Unknown Individual is 1194854091

Main info

Organization
Inactive
20 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1194854091
Phone
(706) 863-9595
Address
PO BOX 3548
Deactivation Date
12 June 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3522658990
Graduation Year
2006 (20 years ago)
PAC ID
9436386166
Group Practice PAC ID
0345146254
Professional Enrollment ID
I20180821002357
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

Provider Addresses for Unknown Individual

  • PO BOX 3548

    AUGUSTA, GA 309143548

    Phone: (706) 863-9595

    Fax: (706) 868-8375

    Type: Mailing

  • 1416 WAINBROOK DR

    AUGUSTA, GA 309096289

    Phone: (706) 863-9595

    Fax: (706) 868-8375

    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.

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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
15003Preparation of skin graft site of trunk, arms, or legs, each additional 100.0 sq cm or 1% body area for infants and children, or less30512$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes6925$0
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes5723$0
99291Critical care, first 30-74 minutes4921$0
15002Preparation of skin graft site of trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less1713$0
View full utilization report →

Insurance plans in this area (ZIP 30914)

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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: 0345146254View full group profile

Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1194854091 is assigned to Unknown Individual under the national enumeration system.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
What kind of provider is Unknown Individual?
The page reflects Trauma Surgery Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Augusta, Georgia because that is what the record indicates for Unknown Individual.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1194854091. Always confirm identity and privileges with the practice and licensing boards.

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