Unknown Individual – Family Medicine Physician, NPI 1538257563

Unknown Individual is a healthcare provider. based in Clinton, Indiana. specializing in Family Medicine Physician. They hold a License No. 01020511 (IN). The NPI Number for Unknown Individual is 1538257563

Main info

Organization
Inactive
62 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1538257563
Phone
(765) 832-9301
Address
PO BOX 266
Deactivation Date
7 February 2024

Doctor Profile

Medical School Name
INDIANA UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
7658322464
Graduation Year
1964 (62 years ago)
PAC ID
2769571876
Group Practice PAC ID
5991809543
Professional Enrollment ID
I20071127000635
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

  • 266, Dickson Point Road, Plattsburgh, Clinton County, New York, 12901, United States

    CLINTON, IN 478420266

    Phone: (765) 832-9301

    Fax: (765) 832-9302

    Type: Mailing

  • 503, East Anderson Street, Rockville, Parke County, Indiana, 47872, United States

    ROCKVILLE, IN 478721008

    Phone: (765) 569-3182

    Fax: (765) 832-2950

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 31 Open Payments records for all available years, with a total value of $1,218.

Total Amount is formed as General ($1,218) + Research ($0) + Ownership ($0) = $1,218.

Last reported payment date: 2023-12-26 • Largest payer in this snapshot: Novo Nordisk Inc ($347).

Total Amount

$1,218

General + Research + Ownership

Payments

31

Total payment records

General Amount

$1,218

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-12-26

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes421138$0
96372Injection of drug or substance under skin or into muscle6629$0
J3301Injection, triamcinolone acetonide, not otherwise specified, 10 mg6013$0
J0696Injection, ceftriaxone sodium, per 250 mg5515$0
99214Established patient office or other outpatient visit, 30-39 minutes2319$0
View full utilization report →

Insurance plans in this area (ZIP 47842)

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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 MEDICINEIN83036Hemoglobin A1C level4940

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: 5991809543View full group profile

Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1538257563.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where in Indiana is Unknown Individual registered?
Use Clinton, Indiana as the headline location for Unknown Individual here.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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