Unknown Individual – Orthopaedic Surgery Physician, NPI 1184685737

Unknown Individual is a healthcare provider. based in Pueblo, Colorado. specializing in Orthopaedic Surgery Physician. They hold a License No. 17496 (CO). The NPI Number for Unknown Individual is 1184685737

Main info

Organization
Inactive
62 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1184685737
Phone
(719) 553-2200
Address
PO BOX 9000
Deactivation Date
19 June 2024

Doctor Profile

Medical School Name
OHIO MEDICAL UNIVERSITY
Secondary Phone
-
Graduation Year
1964 (62 years ago)
PAC ID
4688564487
Professional Enrollment ID
I20100218000026
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

  • 9000, Meredith Place, Beverly Hills, Los Angeles County, California, 90210, United States

    PUEBLO, CO 810089000

    Phone: (719) 553-2200

    Fax: (719) 553-2216

    Type: Mailing

  • Parker Boulevard, Pueblo, Pueblo County, Colorado, 81008, United States of America

    PUEBLO, CO 810082212

    Phone: (719) 553-2200

    Fax: (719) 553-2216

    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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
J3301Injection, triamcinolone acetonide, not otherwise specified, 10 mg54338$0
99213Established patient office or other outpatient visit, 20-29 minutes168104$0
99214Established patient office or other outpatient visit, 30-39 minutes9969$0
73502X-ray of hip, 2-3 views6850$0
99204New patient office or other outpatient visit, 45-59 minutes6767$0
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Insurance plans in this area (ZIP 81008)

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Provider's Procedures

Unknown Individual performs procedures in Orthopaedic Surgery Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
ORTHOPEDIC SURGERYCO27447Repair of knee joint2825
ORTHOPEDIC SURGERYCO73110X-ray of wrist, minimum of 3 views8744
ORTHOPEDIC SURGERYCO73562X-ray of knee, 3 views12374
ORTHOPEDIC SURGERYCO73630X-ray of foot, minimum of 3 views5938

Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1184685737 in the public NPI dataset.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Orthopaedic Surgery Physician in this dataset. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Pueblo, Colorado may find Unknown Individual in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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