Unknown Individual – Addiction Medicine (Internal Medicine) Physician, NPI 1962497693

Unknown Individual is a healthcare provider. based in Tucson, Arizona. specializing in Addiction Medicine (Internal Medicine) Physician. They hold a License No. 17963 (AZ). The NPI Number for Unknown Individual is 1962497693

Main info

Organization
Inactive
40 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1962497693
Phone
(520) 721-1887
Address
PO BOX 86537
Deactivation Date
1 June 2022

Doctor Profile

Medical School Name
MAYO MEDICAL SCHOOL
Secondary Phone
5202260560
Graduation Year
1986 (40 years ago)
PAC ID
7517959661
Group Practice PAC ID
7315163938
Professional Enrollment ID
I20040331000352
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

Provider Addresses for Unknown Individual

  • PO BOX 86537

    TUCSON, AZ 857546537

    Phone: (520) 721-1887

    Fax: (520) 372-7126

    Type: Mailing

  • 1021 E PALMDALE ST STE 130

    TUCSON, AZ 857141859

    Phone: (520) 407-5353

    Fax: (520) 372-7370

    Type: Location

  • 5401 E 5th St

    Tucson, AZ 857112333

    Phone: (520) 879-6680

    Fax: (520) 903-1130

    Type: Location

  • 3939 S Park Ave Ste 150-190

    Tucson, AZ 857141635

    Phone: (520) 333-4320

    Fax: (520) 207-0542

    Type: Location

  • 2499 E Ajo Way

    Tucson, AZ 857136202

    Phone: (520) 901-2300

    Fax: (520) 618-6702

    Type: Location

  • 2273 E Wilcox Dr

    Sierra Vista, AZ 856352755

    Phone: (520) 226-0560

    Fax: (520) 226-0586

    Type: Location

  • 5055 E Broadway Blvd Ste A200

    Tucson, AZ 857113649

    Phone: (520) 901-4800

    Fax: (520) 901-4700

    Type: Location

  • 1021 E Palmdale St Ste 130

    Tucson, AZ 857141859

    Phone: (520) 407-5353

    Fax: (520) 372-7370

    Type: Location

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.

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 85754)

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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: 7315163938View full group profile

Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1962497693?
NPI 1962497693 belongs to Unknown Individual; compare other details if you need extra assurance.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Addiction Medicine (Internal Medicine) Physician. Clinical services aligned with this taxonomy classification.
Where in Arizona is Unknown Individual registered?
Use Tucson, Arizona as the headline location for Unknown Individual here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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