Unknown Individual – Podiatrist, NPI 1487602520

Unknown Individual is a healthcare provider. based in Dripping springs, Texas. specializing in Podiatrist. They hold a License No. E4405 (CA). The NPI Number for Unknown Individual is 1487602520

Main info

Organization
Inactive
26 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1487602520
Phone
(512) 894-5100
Address
170 Benney Lane
Deactivation Date
16 August 2023

Doctor Profile

Medical School Name
CALIFORNIA SCHOOL OF PODIATRIC MEDICINE
Secondary Phone
5124474122
Graduation Year
2000 (26 years ago)
PAC ID
9638127715
Group Practice PAC ID
7719119148
Professional Enrollment ID
I20050111000362
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 170 Benney Lane

    Dripping Springs, TX 786205558

    Phone: (512) 894-5100

    Fax: (512) 614-4131

    Type: Location

  • 5625, Eiger Road, Austin, Travis County, Texas, 78735, United States

    SUITE 110

    AUSTIN, TX 787358977

    Phone: (512) 447-4122

    Fax: (512) 614-4131

    Type: Mailing

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 78620)

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Provider's Procedures

Unknown Individual performs procedures in Podiatrist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PODIATRYTX11042Removal of skin and tissue first 20 sq cm or less6832

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: 7719119148View full group profile
NameSpecialtyState
P O D I A T R YTX
P O D I A T R YTX

Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1487602520.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Podiatrist. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Dripping Springs, Texas in our summary view.
Why does Unknown Individual have multiple addresses?
3 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.