Unknown Individual – Pediatric Pathology Physician, NPI 1609822568

Unknown Individual is a healthcare provider. based in Aurora, Colorado. specializing in Pediatric Pathology Physician. They hold a License No. 58923 (MN). The NPI Number for Unknown Individual is 1609822568

Main info

Organization
Inactive
29 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1609822568
Phone
(720) 777-1234
Address
13123 E 16th Ave
Deactivation Date
6 September 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6029331000
Graduation Year
1997 (29 years ago)
PAC ID
3375693344
Group Practice PAC ID
0446278584
Professional Enrollment ID
I20180410002805
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:0State licenses:3Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 13123 E 16th Ave

    Aurora, CO 800457106

    Phone: (720) 777-1234

    Type: Location

  • 2525 Chicago Ave

    Minneapolis, MN 554044518

    Phone: (612) 813-6711

    Fax: (612) 813-7721

    Type: Location

  • East Camelback Road, Phoenix, Maricopa County, Arizona, 85018, United States

    PHOENIX, AZ 850182327

    Phone: (602) 933-1813

    Type: Mailing

  • Phoenix Children's Hospital, 1919, East Thomas Road, Bronze Boot, Phoenix, Maricopa County, Arizona, 85016, United States

    PHOENIX, AZ 850167710

    Phone: (602) 933-1283

    Fax: (602) 933-1284

    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 80045)

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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: 0446278584View full group profile

Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1609822568 when you need to reference Unknown Individual in forms, claims, or directories.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Pediatric Pathology Physician. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Aurora, Colorado for Unknown Individual based on available NPPES addresses.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1609822568. Always confirm identity and privileges with the practice and licensing boards.

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