Unknown Individual – Medical Physician Assistant, NPI 1073863213

Unknown Individual is a healthcare provider. based in Lakewood, Colorado. specializing in Medical Physician Assistant. They hold a License No. PA0004176 (CO). The NPI Number for Unknown Individual is 1073863213

Main info

Organization
Inactive
14 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1073863213
Phone
(303) 595-2727
Address
11700 W 2ND PL
Deactivation Date
30 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3036952600
Graduation Year
2012 (14 years ago)
PAC ID
2264684794
Group Practice PAC ID
0244459998
Professional Enrollment ID
I20150204000273

Contacts

Secure Messaging
JOSHUA.REYNOLDS@hca3.eclinicaldirectplus.com
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness85
Years active:0State licenses:2Other namesUpdated within 12 months

Provider Addresses for Unknown Individual

  • 11700 W 2ND PL

    SUITE 350

    LAKEWOOD, CO 802281704

    Phone: (303) 595-2727

    Fax: (303) 595-2626

    Type: Location

  • 4545 E 9TH AVE STE 670

    DENVER, CO 802203918

    Phone: (303) 331-9121

    Type: Location

  • 11700 W 2nd Pl

    Suite 350

    Lakewood, CO 802281704

    Phone: (303) 595-2727

    Fax: (303) 595-2626

    Type: Location

  • 4545 E 9th Ave Ste 670

    Denver, CO 802203918

    Phone: (303) 331-9121

    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 80228)

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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: 0244459998View full group profile
NameSpecialtyState
Internal Medicine, Cardiovascular Disease (Cardiology)CO
Nurse PractitionerCO
Physician AssistantCO
-CO
Physician AssistantWI
Thoracic Surgery, Cardiac Surgery, General SurgeryCO
Physician AssistantCO
Thoracic Surgery, Cardiac SurgeryCO
Thoracic Surgery, General SurgeryCO
Physician AssistantCO

Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?
The NPI 1073863213 uniquely identifies Unknown Individual in U.S. healthcare data.
Does inactive mean outdated data for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
How should patients interpret Unknown Individual's specialty?
The extract shows Medical Physician Assistant for Unknown Individual. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Lakewood, Colorado?
For routing, start with Lakewood, Colorado for Unknown Individual, then verify phone and hours locally.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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