Unknown Individual – Plastic and Reconstructive Surgery Physician, NPI 1295794477

Unknown Individual is a healthcare provider. based in Bradenton, Florida. specializing in Plastic and Reconstructive Surgery Physician. They hold a License No. ME60145 (FL). The NPI Number for Unknown Individual is 1295794477

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1295794477
Phone
(941) 792-4157
Address
5807 21ST AVE W
Deactivation Date
3 January 2023
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

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Provider Addresses for Unknown Individual

  • 5807, 21st Avenue West, Bradenton, Manatee County, Florida, 34209, United States

    BRADENTON, FL 34209

    Phone: (941) 792-4157

    Fax: (941) 794-3277

    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 $336.

Total Amount is formed as General ($336) + Research ($0) + Ownership ($0) = $336.

Last reported payment date: 2023-01-10 • Largest payer in this snapshot: Allergan, Inc. ($336).

Total Amount

$336

General + Research + Ownership

Payments

1

Total payment records

General Amount

$336

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-01-10

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Allergan, Inc.$336
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 34209)

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Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1295794477 in the public NPI dataset.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's primary classification?
Plastic and Reconstructive Surgery Physician is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Bradenton, Florida in the data we show; additional addresses may exist on the full record.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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