Unknown Individual – Surgery Physician, NPI 1275621344

Unknown Individual is a healthcare provider. based in Englewood, Colorado. specializing in Surgery Physician. They hold a License No. 30788 (CO). The NPI Number for Unknown Individual is 1275621344

Main info

Organization
Inactive
41 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1275621344
Phone
(303) 957-1310
Address
3333 S BANNOCK ST
Deactivation Date
23 February 2024

Doctor Profile

Medical School Name
BAYLOR COLLEGE OF MEDICINE
Secondary Phone
7204555000
Graduation Year
1985 (41 years ago)
PAC ID
0345292959
Group Practice PAC ID
2961724190
Professional Enrollment ID
I20110119001346

Contacts

Secure Messaging
richard.tillquist@surgone.directbygreenway.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness85
Years active:0State licenses:1Other namesUpdated within 12 months

Provider Addresses for Unknown Individual

  • Wells Fargo, 3333, South Bannock Street, Englewood, Arapahoe County, Colorado, 80113-1525, United States

    SUITE 350

    ENGLEWOOD, CO 801102432

    Phone: (303) 957-1310

    Fax: (303) 761-4252

    Type: Mailing

  • 701 E HAMPDEN AVE STE 420

    ENGLEWOOD, CO 801132760

    Phone: (303) 789-1877

    Fax: (303) 789-2628

    Type: Location

  • 601, East Hampden Avenue, Englewood, Arapahoe County, Colorado, 80113, United States

    SUITE 470

    ENGLEWOOD, CO 801133781

    Phone: (303) 789-1877

    Fax: (303) 789-2628

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $5.

Total Amount is formed as General ($5) + Research ($0) + Ownership ($0) = $5.

Last reported payment date: 2024-01-09 • Largest payer in this snapshot: Intuitive Surgical, Inc. ($5).

Total Amount

$5

General + Research + Ownership

Payments

1

Total payment records

General Amount

$5

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-01-09

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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
99203New patient office or other outpatient visit, 30-44 minutes2525$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes2412$0
99221Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes1616$0
View full utilization report →

Insurance plans in this area (ZIP 80110)

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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: 2961724190View full group profile
NameSpecialtyState
-CO
-CO
O T O L A R Y N G O L O G YCO
General SurgeryCO
General SurgeryCO
Surgical OncologyCO
-CO
General SurgeryOK
General Surgery, Surgical OncologyCO

Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1275621344; it appears in the national provider directory.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
What kind of provider is Unknown Individual?
The page reflects Surgery Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Englewood, Colorado for Unknown Individual; expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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