Unknown Individual – Physician Assistant, NPI 1265779474

Unknown Individual is a healthcare provider. based in Palm beach gardens, Florida. specializing in Physician Assistant. They hold a License No. PA9107021 (FL). The NPI Number for Unknown Individual is 1265779474

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1265779474
Phone
(561) 635-4441
Address
700 Village Square Xing Ste 101
Deactivation Date
18 January 2023
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience18
Completeness75
Years active:0State licenses:2Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 700 Village Square Xing Ste 101

    Palm Beach Gardens, FL 334104532

    Phone: (561) 635-4441

    Type: Location

  • 6555 Chester Ave Ste 1

    Jacksonville, FL 322172279

    Phone: (904) 265-8209

    Fax: (045) 033-5779

    Type: Location

  • 367 S. GULPH RD

    ATT IPM CREDENTIALING

    KING OF PRUSSIA, PA 194063121

    Phone: (561) 333-4000

    Type: Mailing

  • 3319 S STATE ROAD 7 STE 102

    WELLINGTON, FL 334498099

    Phone: (561) 333-4000

    Fax: (561) 333-8851

    Type: Location

  • 4209 WELLINGTON SHORES DR

    WELLINGTON, FL 334498351

    Phone: (561) 635-4441

    Fax: (904) 503-3577

    Type: Mailing

  • 13001 SOUTHERN BLVD

    LOXAHATCHEE, FL 334709203

    Phone: (561) 635-4441

    Fax: (904) 503-3577

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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 33410)

Loading plans...

Reviews

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

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1265779474 if you need a stable reference for Unknown Individual.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Physician Assistant. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Palm Beach Gardens, Florida for Unknown Individual; download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

Similar Providers

PAUL I AVIDON (PA)

Surgical Physician Assistant
9401 SW Discovery Way
NPI: 1265417802

KIMBERLI S JOHNSTON (PA-C)

Physician Assistant
1309 N Flagler Dr
NPI: 1932173895

TYRONE FARIAS (PA)

Physician Assistant
PO BOX 863481
NPI: 1245208776
4510 DONALD ROSS RD
NPI: 1700831476

ROBIN J HAHNER (P.A.-C)

Physician Assistant
3370, Burns Road, Palm Beach Gardens, North Palm Beach, Palm Beach County, Florida, 33410, United States
NPI: 1992749758

MS. TARA JO DUQUETTE (PA-C)

Physician Assistant
9235 67TH AVE E
NPI: 1427094994

MR. GEORGE BROWN (P.A.)

Physician Assistant
VA MEDICAL CENTER (548/110)
NPI: 1689600819

CHARLENE A GUTZMORE (P.A.-C)

Physician Assistant
PO BOX 31448
NPI: 1518994110

DAVID M GONDEK (PA-C)

Surgical Physician Assistant
180 JFK DR STE 100
NPI: 1487684528