Unknown Individual – Neurology Physician, NPI 1629070412

Unknown Individual is a healthcare provider. based in Colorado springs, Colorado. specializing in Neurology Physician. They hold a License No. 35199 (CO). The NPI Number for Unknown Individual is 1629070412

Main info

Organization
Inactive
44 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1629070412
Phone
(719) 473-3272
Address
2312 N NEVADA AVE
Deactivation Date
24 March 2023

Doctor Profile

Medical School Name
GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
7194733272
Graduation Year
1982 (44 years ago)
PAC ID
6507753845
Group Practice PAC ID
9638073612
Professional Enrollment ID
I20090813000051
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

  • 2312, North Nevada Avenue, Colorado Springs, El Paso County, Colorado, 80907, United States

    SUITE 100

    COLORADO SPRINGS, CO 809075302

    Phone: (719) 473-3272

    Fax: (719) 389-1191

    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)

CMS reports 6 Open Payments records for all available years, with a total value of $122.

Total Amount is formed as General ($122) + Research ($0) + Ownership ($0) = $122.

Last reported payment date: 2023-01-25 • Largest payer in this snapshot: Octapharma USA, Inc. ($25).

Total Amount

$122

General + Research + Ownership

Payments

6

Total payment records

General Amount

$122

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-01-25

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
99214Established patient office or other outpatient visit, 30-39 minutes2222$0
View full utilization report →

Insurance plans in this area (ZIP 80907)

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Provider's Procedures

Unknown Individual performs procedures in Neurology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
NEUROLOGYCO96375Injection of different drug or substance into a vein for therapy, diagnosis, or prevention9211

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: 9638073612View full group profile
NameSpecialtyState
Nurse PractitionerCO
O P T O M E T R YCA
-CO
Occupational Therapist In Private PracticeCO
N E U R O L O G YCO
Physical Therapist In Private PracticeCO
-CO
Physician AssistantCO
Clinical PsychologistCO
Physician AssistantCO

Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1629070412.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Neurology Physician. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Colorado Springs, Colorado may find Unknown Individual in results; validate coverage separately.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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