Unknown Individual – Pulmonary Disease Physician, NPI 1932169042

Unknown Individual is a healthcare provider. based in Meridian, Idaho. specializing in Pulmonary Disease Physician. They hold a License No. M-5647 (ID). The NPI Number for Unknown Individual is 1932169042

Main info

Organization
Inactive
45 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1932169042
Phone
(208) 302-2100
Address
3340 EAST GOLDSTONE WAY
Deactivation Date
27 September 2024

Doctor Profile

Medical School Name
UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
1981 (45 years ago)
PAC ID
7517874100
Group Practice PAC ID
3476462359
Professional Enrollment ID
I20040715000999
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience18
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 3340 EAST GOLDSTONE WAY

    MERIDIAN, ID 836421026

    Phone: (208) 302-2100

    Fax: (208) 302-2125

    Type: Mailing

  • East Hawaii Avenue, Nampa, Canyon County, Idaho, 83686, United States

    NAMPA, ID 83686

    Phone: (208) 302-2100

    Fax: (208) 302-2125

    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.

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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 83642)

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Provider's Procedures

Unknown Individual performs procedures in Pulmonary Disease Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
CRITICAL CARE (INTENSIVISTS)ID94060Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration298289

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: 3476462359View full group profile

Reviews

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Frequently asked questions

What is the standard ID for Unknown Individual in the U.S.?
In the U.S., Unknown Individual is identified by NPI 1932169042.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Pulmonary Disease Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Meridian, Idaho in registry-derived data.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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