Unknown Individual – Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician, NPI 1396746210

Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Unknown Individual is a healthcare provider. based in Atlanta, Georgia. specializing in Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician. They hold a License No. 31077 (MO). The NPI Number for Unknown Individual is 1396746210

Main info

Organization

Inactive

59 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1396746210

Phone

(618) 244-3322

Address

PO BOX 116757

Deactivation Date

8 February 2023

Doctor Profile

Medical School Name

SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE

Secondary Phone

3148657000

Graduation Year

1967 (59 years ago)

PAC ID

6901954205

Group Practice PAC ID

0941259063

Professional Enrollment ID

I20090424000173

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

PO BOX 116757
ATLANTA, GA 303686757
Phone: (618) 244-3322
Type: Mailing
Saint Alexius Hospital, 3933, South Broadway, Marine Villa, City of Saint Louis, Missouri, 63118, United States
SAINT LOUIS, MO 631184601
Phone: (314) 865-7000
Fax: (314) 544-8305
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 30368)

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Provider's Procedures

Unknown Individual performs procedures in Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
GENERAL SURGERY	MO	36556	Insertion of central venous catheter for infusion, patient 5 years or older	20	19

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: 0941259063View full group profile

Name	Specialty	State
DR. JOSE I ALVAREZ (MD)	-	IL
DR. SONNY S SAGGAR (M.D.)	-	MO
DR. SANA ULLAH (M.D.)	-	MO
FEDERICO J JR. JIMENEZ (M.D.)	-	MO
Unknown Individual	-	MO

Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?

Save NPI 1396746210 if you need a stable reference for Unknown Individual.

How do I interpret inactive records for Unknown Individual?

Treat inactive as a signal to verify Unknown Individual through official channels.

What kind of provider is Unknown Individual?

The page reflects Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.

What location shows for Unknown Individual?

We surface Atlanta, Georgia for Unknown Individual based on available NPPES addresses.

Does Medicare enrollment show here?

Medicare enrollment screens are separate from the basic NPI extract shown here.