Unknown Individual – Psychiatry Physician, NPI 1073508495

Unknown Individual is a healthcare provider. based in Grand junction, Colorado. specializing in Psychiatry Physician. They hold a License No. 28579 (CO). The NPI Number for Unknown Individual is 1073508495

Main info

Organization
Inactive
52 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1073508495
Phone
(970) 241-1983
Address
1400 N 7TH ST
Deactivation Date
15 May 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9706971020
Graduation Year
1974 (52 years ago)
PAC ID
9234318825
Group Practice PAC ID
6002113057
Professional Enrollment ID
I20110128000208
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

  • Eureka! McConnell Science Museum, 1400, North 7th Street, Grand Junction, Mesa County, Colorado, 81501, United States

    MESA BEHAVIORAL MEDICINE CLINIC PC

    GRAND JUNCTION, CO 815013004

    Phone: (970) 241-1983

    Fax: (970) 242-6135

    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)

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90868Treatment using magnetic field to stimulate nerve cells in brain, subsequent delivery and management24712$0
90792Psychiatric diagnostic evaluation with medical services2726$0
99214Established patient office or other outpatient visit, 30-39 minutes1211$0
View full utilization report →

Insurance plans in this area (ZIP 81501)

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Provider's Procedures

Unknown Individual performs procedures in Psychiatry Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PSYCHIATRYCO90833Psychotherapy, 30 minutes with patient and/or family member584168

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: 6002113057View full group profile
NameSpecialtyState
-CO
P S Y C H I A T R YWA
-CO
P S Y C H I A T R YNV
P S Y C H I A T R YCO
Psychiatry, Neurology, Neurosurgery, NeurologySC
-CO
P S Y C H I A T R YID

Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1073508495 for Unknown Individual, then check state licensing separately.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Psychiatry Physician in this dataset. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Grand Junction, Colorado; more addresses can appear in NPPES.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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