Unknown Individual – Neurology Physician, NPI 1013129972

Unknown Individual is a healthcare provider. based in Phoenix, Arizona. specializing in Neurology Physician. They hold a License No. 53122 (AZ). The NPI Number for Unknown Individual is 1013129972

Main info

Organization
Inactive
22 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1013129972
Phone
(602) 406-6262
Address
240 W THOMAS RD # 404
Deactivation Date
15 May 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6024066017
Graduation Year
2004 (22 years ago)
PAC ID
1153494885
Group Practice PAC ID
4486646197
Professional Enrollment ID
I20170206002205
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:0State licenses:4Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 404, West Thomas Road, Encanto, Phoenix, Maricopa County, Arizona, 85013, United States

    PHOENIX, AZ 850134407

    Phone: (602) 406-6262

    Fax: (602) 406-6261

    Type: Mailing

  • 888 W Bonneville Ave

    Las Vegas, NV 891060100

    Phone: (702) 483-6000

    Fax: (702) 483-6039

    Type: Location

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 $15.

Total Amount is formed as General ($15) + Research ($0) + Ownership ($0) = $15.

Last reported payment date: 2023-08-23 • Largest payer in this snapshot: ABBVIE INC. ($15).

Total Amount

$15

General + Research + Ownership

Payments

1

Total payment records

General Amount

$15

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-08-23

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$15
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 85013)

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Provider's Procedures

Unknown Individual performs procedures in Neurology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
NEUROLOGYNV97001Physical therapy evaluation1616
NEUROLOGYNV97110Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes26456

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4486646197View full group profile
NameSpecialtyState
-AZ
-IL
Infectious Disease, Internal MedicineWA
-AZ
Pulmonary Disease, Critical Care (Intensivists)AZ
Diagnostic RadiologyAZ
Nurse PractitionerAZ
Nurse PractitionerAZ
Colorectal Surgery (Proctology)AZ
Physician AssistantAZ

Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1013129972 on file in the registry.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Neurology Physician in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Phoenix, Arizona.
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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