Unknown Individual – Geriatric Medicine (Internal Medicine) Physician, NPI 1124047428

Unknown Individual is a healthcare provider. based in St petersburg, Florida. specializing in Geriatric Medicine (Internal Medicine) Physician. They hold a License No. ME55851 (FL). The NPI Number for Unknown Individual is 1124047428

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1124047428
Phone
(727) 527-8788
Address
5880 49TH STREET NORTH
Deactivation Date
7 August 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 5880 49TH STREET NORTH

    SUITE 101 N

    ST PETERSBURG, FL 337092148

    Phone: (727) 527-8788

    Fax: (727) 527-8828

    Type: Location

  • 49th Street North, Live Oak, Saint Petersburg, Pinellas County, Florida, 33710, United States

    SUITE 101-N

    ST PETERSBURG, FL 337092150

    Phone: (727) 527-8788

    Fax: (727) 527-8828

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $1,575.

Total Amount is formed as General ($1,575) + Research ($0) + Ownership ($0) = $1,575.

Last reported payment date: 2023-11-02 • Largest payer in this snapshot: Abbott Laboratories ($1,575).

Total Amount

$1,575

General + Research + Ownership

Payments

3

Total payment records

General Amount

$1,575

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-11-02

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Abbott Laboratories$1,575
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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33709)

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Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1124047428 for Unknown Individual.
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 Geriatric Medicine (Internal Medicine) Physician. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in St Petersburg, Florida?
For routing, start with St Petersburg, Florida for Unknown Individual, then verify phone and hours locally.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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