Unknown Individual – Internal Medicine Physician, NPI 1831163294
Internal Medicine Physician
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
4905, 108th Street Southwest, Bridgeport Way Apartments, Lakeview, Lakewood, Pierce County, Washington, 98499, United States
LAKEWOOD, WA 98499
Phone: (253) 472-8389
Fax: (253) 472-4977
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)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 250 | 75 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 63 | 40 | $0 |
| 93000 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report | 58 | 55 | $0 |
| 99497 | Advance care planning, first 30 minutes | 57 | 57 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 56 | 56 | $0 |
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