Unknown Individual – Emergency Medicine Physician, NPI 1366404790

Unknown Individual is a healthcare provider. based in Atlanta, Georgia. specializing in Emergency Medicine Physician. They hold a License No. 228674 (NY). The NPI Number for Unknown Individual is 1366404790

Main info

Organization
Inactive
27 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1366404790
Phone
(800) 377-8721
Address
PO BOX 409041
Deactivation Date
5 June 2025

Doctor Profile

Medical School Name
NEW YORK COLLEGE OF OSTEO MEDICINE OF NEW YORK INSTITUTE OF TECHNOLOGY
Secondary Phone
6783126800
Graduation Year
1999 (27 years ago)
PAC ID
8820980840
Group Practice PAC ID
0840373619
Professional Enrollment ID
I20200116002914
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

  • PO BOX 409041

    ATLANTA, GA 303849041

    Phone: (800) 377-8721

    Fax: (304) 523-2241

    Type: Mailing

  • NYU Langone Hospital-Brooklyn, 150, 55th Street, Sunset Park, Brooklyn, Kings County, New York, 11220, United States

    BROOKLYN, NY 112202559

    Phone: (718) 630-7185

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $148.

Total Amount is formed as General ($148) + Research ($0) + Ownership ($0) = $148.

Last reported payment date: 2023-11-20 • Largest payer in this snapshot: Getinge USA Sales, LLC ($109).

Total Amount

$148

General + Research + Ownership

Payments

3

Total payment records

General Amount

$148

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-11-20

Latest reported date

Top Companies

Largest payers in this snapshot

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
99285Emergency department visit with high level of medical decision making225216$0
99284Emergency department visit with moderate level of medical decision making4646$0
99291Critical care, first 30-74 minutes3232$0
99236Initial hospital care with same-day admission and discharge with high level of medical decision making, per day, if using time, at least 85 minutes1717$0
View full utilization report →

Insurance plans in this area (ZIP 30384)

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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: 0840373619View full group profile
NameSpecialtyState
Nurse PractitionerGA
-GA
Emergency MedicineGA
Emergency MedicineGA
Emergency Medicine, HospitalistFL
Emergency MedicineGA
Emergency MedicineGA
-GA
-NY
Emergency MedicineGA

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 1366404790.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
Where in Georgia is Unknown Individual registered?
Use Atlanta, Georgia as the headline location for Unknown Individual here.
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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