Unknown Individual – Family Medicine Physician, NPI 1689645657

Unknown Individual is a healthcare provider. based in Belfast, Maine. specializing in Family Medicine Physician. They hold a License No. K3403 (TX). The NPI Number for Unknown Individual is 1689645657

Main info

Organization
Inactive
32 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1689645657
Phone
(903) 342-9800
Address
PO BOX 12251
Deactivation Date
11 September 2024

Doctor Profile

Medical School Name
UNIVERSITY OF NORTH TEXAS HSC, COLLEGE OF OSTEOPATHIC MED
Secondary Phone
-
Graduation Year
1994 (32 years ago)
PAC ID
8022015338
Professional Enrollment ID
I20061030000513
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 12251

    BELFAST, ME 049154013

    Phone: (903) 342-9800

    Fax: (903) 342-9809

    Type: Mailing

  • CHRISTUS Mother Frances Hospital - Winnsboro, 719, West Coke Road, Winnsboro, Wood County, Texas, 75494, United States

    BUILDING 2

    WINNSBORO, TX 754943060

    Phone: (903) 342-9800

    Fax: (903) 342-9809

    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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
J3301Injection, triamcinolone acetonide, not otherwise specified, 10 mg1,220188$0
99213Established patient office or other outpatient visit, 20-29 minutes596285$0
99214Established patient office or other outpatient visit, 30-39 minutes580304$0
99490Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month45361$0
99497Advance care planning, first 30 minutes337335$0
View full utilization report →

Insurance plans in this area (ZIP 04915)

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Provider's Procedures

Unknown Individual performs procedures in Family Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINETX85610Blood test, clotting time12220

Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1689645657 for Unknown Individual, then check state licensing separately.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Belfast, Maine in the data we show; additional addresses may exist on the full record.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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