Unknown Individual – Nephrology Physician, NPI 1962493379

Unknown Individual is a healthcare provider. based in Macon, Georgia. specializing in Nephrology Physician. They hold a License No. 020786 (GA). The NPI Number for Unknown Individual is 1962493379

Main info

Organization
Inactive
54 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1962493379
Phone
(478) 254-7353
Address
2525 2ND ST
Deactivation Date
16 October 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4782547353
Graduation Year
1972 (54 years ago)
PAC ID
6709793565
Group Practice PAC ID
8527240381
Professional Enrollment ID
I20051006000788
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

  • 2525, 2nd Street, Macon, Bibb County, Georgia, 31206, United States

    SUITE 150

    MACON, GA 312062223

    Phone: (478) 254-7353

    Fax: (478) 471-6874

    Type: Location

  • Macon Post Office, 101, West Dunn Street, Macon, Macon County, Illinois, 62544, United States

    MACON, GA 312084048

    Phone: (478) 254-7353

    Fax: (478) 471-6874

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 11 Open Payments records for all available years, with a total value of $70.

Total Amount is formed as General ($70) + Research ($0) + Ownership ($0) = $70.

Last reported payment date: 2024-09-23 • Largest payer in this snapshot: Travere Therapeutics, Inc. ($70).

Total Amount

$70

General + Research + Ownership

Payments

11

Total payment records

General Amount

$70

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-23

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
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes1,289267$0
90960Dialysis services, 4 or more physician visits per month (20 years or older)34976$0
99239Hospital discharge day management, more than 30 minutes215202$0
99223Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes112108$0
90961Dialysis services, 2-3 physician visits per month (20 years or older)6743$0
View full utilization report →

Insurance plans in this area (ZIP 31206)

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Provider's Procedures

Unknown Individual performs procedures in Nephrology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
INTERNAL MEDICINEGA90935Hemodialysis procedure with one physician evaluation549152

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: 8527240381View full group profile
NameSpecialtyState
Internal Medicine, NephrologyGA
Nephrology, Internal MedicineGA

Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1962493379.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
How should patients interpret Unknown Individual's specialty?
The extract shows Nephrology Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Macon, Georgia. Check all listed addresses for suites or satellite offices.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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