Unknown Individual – Adult Medicine Physician, NPI 1962515072

Unknown Individual is a healthcare provider. based in St augustine, Florida. specializing in Adult Medicine Physician. They hold a License No. ME 33096 (FL). The NPI Number for Unknown Individual is 1962515072

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1962515072
Phone
(904) 829-2141
Address
232 SOUTHPARK CIR E
Deactivation Date
30 August 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 232, Southpark Circle East, St. Augustine South, Saint Johns County, Florida, 32086, United States

    ST AUGUSTINE, FL 320865137

    Phone: (904) 829-2141

    Fax: (904) 829-2141

    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 2 Open Payments records for all available years, with a total value of $213.

Total Amount is formed as General ($213) + Research ($0) + Ownership ($0) = $213.

Last reported payment date: 2023-03-09 • Largest payer in this snapshot: AXOGEN ($127).

Total Amount

$213

General + Research + Ownership

Payments

2

Total payment records

General Amount

$213

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-03-09

Latest reported date

Top Companies

Largest payers in this snapshot

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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 32086)

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Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1962515072.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Adult Medicine Physician. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect St Augustine, Florida as a primary anchor for Unknown Individual unless the record lists multiple sites.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.