Unknown Individual – Surgery Physician, NPI 1295778496

Unknown Individual is a healthcare provider. based in Marion, Indiana. specializing in Surgery Physician. They hold a License No. 01021177 (IN). The NPI Number for Unknown Individual is 1295778496

Main info

Organization
Inactive
60 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1295778496
Phone
(765) 662-8303
Address
330 N WABASH AVE
Deactivation Date
26 June 2025

Doctor Profile

Medical School Name
INDIANA UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
1966 (60 years ago)
PAC ID
0446447379
Professional Enrollment ID
I20101204000077
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

  • 330, Wabash Avenue, Wamac, Marion County, Illinois, 62801, United States

    MARION, IN 469522600

    Phone: (765) 662-8303

    Fax: (765) 664-4523

    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 16 Open Payments records for all available years, with a total value of $368.

Total Amount is formed as General ($368) + Research ($0) + Ownership ($0) = $368.

Last reported payment date: 2024-10-18 • Largest payer in this snapshot: Mentor Worldwide LLC ($181).

Total Amount

$368

General + Research + Ownership

Payments

16

Total payment records

General Amount

$368

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-18

Latest reported date

Top Companies

Largest payers in this snapshot

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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 46952)

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Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1295778496 on file in the registry.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Surgery Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Marion?
Public fields place Unknown Individual around Marion, Indiana. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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