Unknown Individual – General Practice Physician, NPI 1013096080

Unknown Individual is a healthcare provider. based in Merced, California. specializing in General Practice Physician. They hold a License No. A50609 (CA). The NPI Number for Unknown Individual is 1013096080

Main info

Organization
Inactive
45 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1013096080
Phone
(209) 725-7149
Address
PO BOX 3768
Deactivation Date
12 December 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2093845766
Graduation Year
1981 (45 years ago)
PAC ID
4880794395
Group Practice PAC ID
4789678111
Professional Enrollment ID
I20070712000861
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Merced Post Office, West 18th Street, Merced, Merced County, California, 95340, United States

    MERCED, CA 953443768

    Phone: (209) 725-7149

    Fax: (209) 726-0134

    Type: Mailing

  • Fountain View Urgent Care, 374, West Olive Avenue, Merced, Merced County, California, 95348, United States

    SUITE A

    MERCED, CA 953483181

    Phone: (209) 384-5766

    Fax: (209) 383-4230

    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 95344)

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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: 4789678111View full group profile
NameSpecialtyState
Family PracticeCA
-CA
-CA
Family Practice, Geriatric MedicineCA
Family PracticeCA
Family PracticeCA
P O D I A T R YCA
Family PracticeCA
Clinical Social WorkerCA
Family PracticeCA

Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1013096080 on file in the registry.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as General Practice Physician. Clinical services aligned with this taxonomy classification.
Where in California is Unknown Individual registered?
Use Merced, California 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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