Unknown Individual – Family Medicine Physician, NPI 1649295403

Unknown Individual is a healthcare provider. based in Kissimmee, Florida. specializing in Family Medicine Physician. They hold a License No. MD33903 (TN). The NPI Number for Unknown Individual is 1649295403

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1649295403
Phone
(407) 343-0542
Address
339 CYPRESS PKWY
Deactivation Date
16 April 2026
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:0State licenses:2Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 339 CYPRESS PKWY

    SUITE 110

    KISSIMMEE, FL 347593302

    Phone: (407) 343-0542

    Fax: (407) 343-0553

    Type: Location

  • Bruce B Downs Boulevard, Wesley Chapel, Pasco County, Florida, 33543, United States

    WESLEY CHAPEL, FL 335449262

    Phone: (407) 343-0542

    Fax: (407) 343-0553

    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.

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20101117001444IEmergency MedicineFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making280272$0
99284Emergency department visit with moderate level of medical decision making228221$0
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only9791$0
99283Emergency department visit with low level of medical decision making3029$0
99291Critical care, first 30-74 minutes1414$0
View full utilization report →

Insurance plans in this area (ZIP 34759)

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Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1649295403 as the unique 10-digit identifier.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Kissimmee?
Unknown Individual currently maps to Kissimmee, Florida in this extract.
Does Unknown Individual accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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