Unknown Individual – Foot & Ankle Surgery Podiatrist, NPI 1629175013

Unknown Individual is a healthcare provider. based in Augusta, Maine. specializing in Foot & Ankle Surgery Podiatrist. They hold a License No. 103534-0501 (UT). The NPI Number for Unknown Individual is 1629175013

Main info

Organization
Inactive
48 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1629175013
Phone
(207) 623-8411
Address
TOGUS VA MEDICAL CENTER
Deactivation Date
17 November 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2077374359
Graduation Year
1978 (48 years ago)
PAC ID
0648309484
Group Practice PAC ID
5496726523
Professional Enrollment ID
I20100603000553
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

Provider Addresses for Unknown Individual

  • TOGUS VA MEDICAL CENTER

    P.O. BOX 3032

    AUGUSTA, ME 043303032

    Phone: (207) 623-8411

    Fax: (207) 621-4882

    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)

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 04330)

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Provider's Procedures

Unknown Individual performs procedures in Foot & Ankle Surgery Podiatrist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PODIATRYME11042Removal of skin and tissue first 20 sq cm or less4019
PODIATRYME11056Removal of 2 to 4 thickened skin growths265146
PODIATRYME73630X-ray of foot, minimum of 3 views7454

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: 5496726523View full group profile
NameSpecialtyState
Clinical Social WorkerME
Family PracticeID
Clinical Social WorkerME
Nurse PractitionerWA
Nurse PractitionerNH
-ME
Nurse PractitionerME
Clinical Social WorkerME
Family PracticeME
-ME

Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1629175013 — the number used across U.S. healthcare to identify this provider.
Is Unknown Individual still active if the NPI shows inactive?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Foot & Ankle Surgery Podiatrist in the directory — Clinical services aligned with this taxonomy classification.
Where in Maine is Unknown Individual registered?
Use Augusta, Maine as the headline location for Unknown Individual here.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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