Unknown Individual – Internal Medicine Physician, NPI 1245396316

Unknown Individual is a healthcare provider. based in Beaumont, Texas. specializing in Internal Medicine Physician. They hold a License No. P8670 (TX). The NPI Number for Unknown Individual is 1245396316

Main info

Organization
Inactive
48 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1245396316
Phone
(409) 813-2332
Address
3406 COLLEGE ST STE 200
Deactivation Date
10 April 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7704604285
Graduation Year
1978 (48 years ago)
PAC ID
2961499785
Group Practice PAC ID
4284951542
Professional Enrollment ID
I20191212000698
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 200, College Street, NR CBD, Beaumont, Jefferson County, Texas, 77701, United States

    BEAUMONT, TX 777014612

    Phone: (409) 813-2332

    Fax: (409) 232-0559

    Type: Mailing

  • College Street, Beaumont, Jefferson County, Texas, 77702, United States

    BEAUMONT, TX 777014612

    Phone: (409) 813-1677

    Fax: (409) 813-1699

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 13 Open Payments records for all available years, with a total value of $234.

Total Amount is formed as General ($234) + Research ($0) + Ownership ($0) = $234.

Last reported payment date: 2023-12-11 • Largest payer in this snapshot: Novartis Pharmaceuticals Corporation ($68).

Total Amount

$234

General + Research + Ownership

Payments

13

Total payment records

General Amount

$234

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-12-11

Latest reported date

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
J0897Injection, denosumab, 1 mg2,46027$0
99213Established patient office or other outpatient visit, 20-29 minutes966461$0
J3301Injection, triamcinolone acetonide, not otherwise specified, 10 mg942126$0
36415Insertion of needle into vein for collection of blood sample472258$0
85651Red blood cell sedimentation rate, to detect inflammation, non-automated415230$0
View full utilization report →

Insurance plans in this area (ZIP 77701)

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Provider's Procedures

Unknown Individual performs procedures in Internal Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
RHEUMATOLOGYTX20610Aspiration and/or injection of large joint or joint capsule1915
RHEUMATOLOGYTX73630X-ray of foot, minimum of 3 views5226

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: 4284951542View full group profile
NameSpecialtyState
Nurse PractitionerGA
-GA
Nurse PractitionerGA
Diagnostic RadiologyGA
Nurse PractitionerGA
Internal MedicineGA
Internal Medicine, Allergy/ImmunologyGA
General PracticeGA
Nurse PractitionerGA
Internal MedicineGA

Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1245396316.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Beaumont?
Public fields place Unknown Individual around Beaumont, Texas. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.