Unknown Individual – Emergency Medicine Physician, NPI 1043230840

Unknown Individual is a healthcare provider. based in Virginia beach, Virginia. specializing in Emergency Medicine Physician. They hold a License No. 0101030029 (VA). The NPI Number for Unknown Individual is 1043230840

Main info

Organization
Inactive
51 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1043230840
Phone
(757) 853-1380
Address
236 CLEARFIELD AVE STE 215
Deactivation Date
2 August 2023

Doctor Profile

Medical School Name
UNIVERSITY OF VIRGINIA SCHOOL OF MEDICINE
Secondary Phone
7579415600
Graduation Year
1975 (51 years ago)
PAC ID
4880597269
Group Practice PAC ID
9234041948
Professional Enrollment ID
I20070502000275
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 215, Clearfield Avenue, Boulevard Manor, Virginia Beach, Virginia, 23462, United States

    VIRGINIA BEACH, VA 234621893

    Phone: (757) 853-1380

    Type: Location

  • 7447, Central Business Park Drive, Miller Heights, Washington Park, Norfolk, Virginia, 23513, United States

    STE 104

    NORFOLK, VA 235132831

    Phone:

    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 23462)

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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: 9234041948View full group profile

Reviews

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Frequently asked questions

What is the standard ID for Unknown Individual in the U.S.?
In the U.S., Unknown Individual is identified by NPI 1043230840.
What does inactive NPI status mean for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
What does the directory say Unknown Individual does?
Insurance directories may phrase it differently, but here Unknown Individual maps to Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Virginia Beach, Virginia in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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