Unknown Individual – Interventional Cardiology Physician, NPI 1992798243

Unknown Individual is a healthcare provider. based in Longmont, Colorado. specializing in Interventional Cardiology Physician. They hold a License No. MTL-2017-079 (GU). The NPI Number for Unknown Individual is 1992798243

Main info

Organization
Inactive
41 Years Of Experience
Name
Unknown Individual
NPI
1992798243
Phone
(720) 652-8650
Address
2030 MOUNTAIN VIEW AVE
Deactivation Date
22 November 2023

Doctor Profile

Medical School Name
UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Secondary Phone
4064472828
Graduation Year
1985 (41 years ago)
PAC ID
0648268276
Group Practice PAC ID
7911814926
Professional Enrollment ID
I20110715000285
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

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Provider Addresses for Unknown Individual

  • 2030, Mountain View Avenue, Longmont, Boulder County, Colorado, 80501, United States

    STE 300

    LONGMONT, CO 805013178

    Phone: (720) 652-8650

    Fax: (720) 652-8655

    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 2 Open Payments records for all available years, with a total value of $43.

Total Amount is formed as General ($43) + Research ($0) + Ownership ($0) = $43.

Last reported payment date: 2023-03-01 • Largest payer in this snapshot: Novartis Pharmaceuticals Corporation ($43).

Total Amount

$43

General + Research + Ownership

Payments

2

Total payment records

General Amount

$43

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-03-01

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.

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

Insurance plans in this area (ZIP 80501)

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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: 7911814926View full group profile
NameSpecialtyState
Physician AssistantMT
Hospitalist, Internal MedicineMT
Family PracticeMT
A N E S T H E S I O L O G YID
Physician AssistantMT
Nurse PractitionerMT
Certified Registered Nurse Anesthetist (Crna)TX
Internal Medicine, Hematology/OncologyMT
Family Practice, Addiction MedicineMN
-OK

Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1992798243 — is the standard way to identify this listing.
Is Unknown Individual excluded from programs when inactive?
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?
Interventional Cardiology Physician is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Longmont, Colorado in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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