Unknown Individual – Adult Medicine Physician, NPI 1962515072
Adult Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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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
| Company | Amount |
|---|---|
| AXOGEN | $127 |
| Relievant Medsystems, Inc. | $86 |
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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