Unknown Individual – Family Medicine Physician, NPI 1033117296

Unknown Individual is a healthcare provider. based in Post falls, Idaho. specializing in Family Medicine Physician. They hold a License No. O-179 (ID). The NPI Number for Unknown Individual is 1033117296

Main info

Organization
Inactive
35 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1033117296
Phone
(208) 773-1577
Address
1220 E POLSTON AVE
Deactivation Date
26 February 2026

Doctor Profile

Medical School Name
COLLEGE OF OSTEO MED OF THE PACIFIC AT POMONA
Secondary Phone
2087731577
Graduation Year
1991 (35 years ago)
PAC ID
9335034339
Group Practice PAC ID
5991780488
Professional Enrollment ID
I20040218000793
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Loading map...

Provider Addresses for Unknown Individual

  • 1220, East Polston Avenue, Post Falls, Kootenai County, Idaho, 83854, United States

    POST FALLS, ID 83854

    Phone: (208) 773-1577

    Fax: (208) 773-8585

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $16.

Total Amount is formed as General ($16) + Research ($0) + Ownership ($0) = $16.

Last reported payment date: 2024-06-05 • Largest payer in this snapshot: ABBVIE INC. ($16).

Total Amount

$16

General + Research + Ownership

Payments

1

Total payment records

General Amount

$16

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-06-05

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$16
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 83854)

Loading plans...

Provider's Procedures

Unknown Individual performs procedures in Family Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINEID81002Urinalysis, manual test2622
FAMILY MEDICINEID90670Pneumococcal vaccine for injection into muscle3131

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: 5991780488View full group profile
NameSpecialtyState
Family PracticeID
Family PracticeID
Nurse PractitionerID
Nurse PractitionerID
Family PracticeID
Family PracticeID

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1033117296.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Family Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Post Falls, Idaho in the data we show; additional addresses may exist on the full record.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

Similar Providers

MR. ANTHONY D PETERS (DO)

Family Medicine Physician
1220, East Polston Avenue, Post Falls, Kootenai County, Idaho, 83854, United States
NPI: 1033117205

MRS. SHAUNA A SPELLMAN (ARNP)

Family Medicine Physician
1220, East Polston Avenue, Post Falls, Kootenai County, Idaho, 83854, United States
NPI: 1346248507

MR. MORGAN D. FORD (M.D.)

Family Medicine Physician
1220, East Polston Avenue, Post Falls, Kootenai County, Idaho, 83854, United States
NPI: 1114925286

DR. MICHAEL W I MONOHAN (D.O.)

Family Medicine Physician
1220, East Polston Avenue, Post Falls, Kootenai County, Idaho, 83854, United States
NPI: 1942298054

DR. MARK P BORSHEIM (MD)

Family Medicine Physician
8181, North Cornerstone Drive, Hayden, Kootenai County, Idaho, 83835, United States
NPI: 1396728135

DR. THOMAS ARTHUR NEAL (MD)

Family Medicine Physician
Northwest Specialty Hospital Medical Park, 1593, East Polston Avenue, Post Falls, Kootenai County, Idaho, 83854, United States
NPI: 1922079235

DR. RALPH MARC SUTHERLIN (D.O.)

Family Medicine Physician
3340 E. GOLDSTONE WAY
NPI: 1245291772
315 W Dalton Ave Ste A
NPI: 1821040247

DR. LEANNE M ROUSSEAU (M.D.)

Family Medicine Physician
PO BOX 1387
NPI: 1093768707