Unknown Individual – Cardiovascular Disease Physician, NPI 1619943941

Cardiovascular Disease Physician

Unknown Individual is a healthcare provider. based in Dublin, Georgia. specializing in Cardiovascular Disease Physician. They hold a License No. 028227 (GA). The NPI Number for Unknown Individual is 1619943941

Main info

Organization

Inactive

46 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1619943941

Phone

(478) 272-3525

Address

206 HOSPITAL DR STE A

Deactivation Date

5 April 2021

Doctor Profile

Medical School Name

OTHER

Secondary Phone

4782723525

Graduation Year

1980 (46 years ago)

PAC ID

7012940380

Group Practice PAC ID

0941293476

Professional Enrollment ID

I20050916000244

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience24

Completeness75

Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

206 HOSPITAL DR STE A
DUBLIN, GA 310212560
Phone: (478) 272-3525
Fax: (478) 272-3589
Type: Mailing
Hospital Drive, Dublin, Washington Township, Franklin County, Ohio, 43016, United States
DUBLIN, GA 310212989
Phone: (478) 272-3525
Fax: (478) 272-3589
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.

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 31021)

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Provider's Procedures

Unknown Individual performs procedures in Cardiovascular Disease Physician. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
CARDIAC SURGERY	GA	78452	Nuclear medicine study of vessels of heart using drugs or exercise multiple studies	311	306
CARDIAC SURGERY	GA	92928	Catheter insertion of stents in major coronary artery or branch, accessed through the skin	95	74
CARDIAC SURGERY	GA	93458	Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart	149	144

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: 0941293476View full group profile