Unknown Individual – Physician Assistant, NPI 1316045362

Unknown Individual is a healthcare provider. based in Montrose, Colorado. specializing in Physician Assistant. They hold a License No. PA.0004016 (CO). The NPI Number for Unknown Individual is 1316045362

Main info

Organization
Inactive
30 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1316045362
Phone
(970) 497-4921
Address
1550 E NIAGARA RD
Deactivation Date
20 March 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9704974921
Graduation Year
1996 (30 years ago)
PAC ID
9537137609
Group Practice PAC ID
9931411048
Professional Enrollment ID
I20150302000239
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 1550, East Niagara Road, Montrose, Montrose County, Colorado, 81401, United States

    MONTROSE, CO 814015029

    Phone: (970) 497-4921

    Fax: (855) 855-4482

    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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 81401)

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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: 9931411048View full group profile
NameSpecialtyState
Clinical PsychologistAL
Clinical Social WorkerCO
-CO
Physician AssistantCO
Physician AssistantCO
Physician AssistantCO
Nurse PractitionerCO
Family PracticeCO
Family PracticeAZ
Physician AssistantCO

Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1316045362 is assigned to Unknown Individual under the national enumeration system.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Physician Assistant. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Montrose, Colorado for Unknown Individual; download NPPES for the complete set.
What if Montrose, Colorado seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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