Unknown Individual – Nurse Practitioner, NPI 1992789630
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
3705, 9th Avenue, Pear Ridge, Port Arthur, Jefferson County, Texas, 77642, United States
PORT ARTHUR, TX 776424423
Phone: (409) 985-8100
Fax: (409) 985-4778
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)
CMS reports 1 Open Payments records for all available years, with a total value of $24.
Total Amount is formed as General ($24) + Research ($0) + Ownership ($0) = $24.
Last reported payment date: 2023-07-13 • Largest payer in this snapshot: Lilly USA, LLC ($24).
Total Amount
$24
General + Research + Ownership
Payments
1
Total payment records
General Amount
$24
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-07-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lilly USA, LLC | $24 |
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 43 | 26 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 26 | 13 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 13 | 13 | $0 |
Insurance plans in this area (ZIP 77642)
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