Unknown Individual – Internal Medicine Physician, NPI 1962404160

Unknown Individual is a healthcare provider. based in Golden, Colorado. specializing in Internal Medicine Physician. They hold a License No. 37858 (CO). The NPI Number for Unknown Individual is 1962404160

Main info

Organization
Inactive
30 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1962404160
Phone
(303) 716-8013
Address
1707 COLE BLVD
Deactivation Date
20 April 2022

Doctor Profile

Medical School Name
UNIVERSITY OF COLORADO SCHOOL OF MEDICINE, DENVER
Secondary Phone
3039882680
Graduation Year
1996 (30 years ago)
PAC ID
0941195028
Group Practice PAC ID
9537054614
Professional Enrollment ID
I20090616000751
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

  • 1707 COLE BLVD

    STE 100

    GOLDEN, CO 804013220

    Phone: (303) 716-8013

    Fax: (303) 763-5495

    Type: Mailing

  • The RJ Baxter Team - Denver Loan Officer, 165, South Union Boulevard, Lakewood, Jefferson County, Colorado, 80228, United States

    STE 800

    LAKEWOOD, CO 802282215

    Phone: (303) 988-2680

    Fax: (303) 986-8057

    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 $15.

Total Amount is formed as General ($15) + Research ($0) + Ownership ($0) = $15.

Last reported payment date: 2023-03-23 • Largest payer in this snapshot: Alkermes, Inc. ($15).

Total Amount

$15

General + Research + Ownership

Payments

1

Total payment records

General Amount

$15

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-03-23

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Alkermes, Inc.$15
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.

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

Insurance plans in this area (ZIP 80401)

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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: 9537054614View full group profile

Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1962404160 — is the standard way to identify this listing.
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 is Unknown Individual's primary classification?
Internal Medicine Physician is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Golden, Colorado in the data we show; additional addresses may exist on the full record.
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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