Unknown Individual – Surgical Critical Care Physician, NPI 1306800628
Surgical Critical Care Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
1800 MEDICAL CENTER PKWY STE 420
MURFREESBORO, TN 371293193
Phone: (615) 229-5565
Type: Location
1403, Medical Plaza Drive, Sanford, Seminole County, Florida, 32771, United States
SUITE 102
SANFORD, FL 327711000
Phone: (407) 323-7821
Fax: (407) 323-7752
Type: Location
USP Store, 52, Riley Road, North Village, Celebration, Osceola County, Florida, 34747, United States
SUITE 310
CELEBRATION, FL 34747
Phone: (407) 846-2266
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $185.
Total Amount is formed as General ($185) + Research ($0) + Ownership ($0) = $185.
Last reported payment date: 2023-05-24 • Largest payer in this snapshot: Integra LifeSciences Corporation ($152).
Total Amount
$185
General + Research + Ownership
Payments
4
Total payment records
General Amount
$185
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-05-24
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Integra LifeSciences Corporation | $152 |
| Kerecis Limited | $33 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050928001140 | I | General Surgery | FL | TBD |
| I20210524000917 | I | General Surgery | TN | TBD |
| I20230204000130 | I | General Surgery | TX | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
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 37129)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | FL | |
| General Surgery | OK | |
| - | FL | |
| Physician Assistant | FL | |
| - | FL | |
| - | FL |
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