Unknown Individual – Emergency Medicine Physician, NPI 1609850403

Unknown Individual is a healthcare provider. based in Scottsburg, Indiana. specializing in Emergency Medicine Physician. They hold a License No. 01028150A (IN). The NPI Number for Unknown Individual is 1609850403

Main info

Organization
Inactive
48 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1609850403
Phone
(812) 752-7444
Address
1366 N GARDNER ST
Deactivation Date
6 March 2025

Doctor Profile

Medical School Name
INDIANA UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
7655840004
Graduation Year
1978 (48 years ago)
PAC ID
6406845254
Group Practice PAC ID
4385541614
Professional Enrollment ID
I20040510001474
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

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Provider Addresses for Unknown Individual

  • North Gardner Street, Scottsburg, Scott County, Indiana, 47170, United States

    STE 140

    SCOTTSBURG, IN 47170

    Phone: (812) 752-7444

    Fax: (812) 752-6855

    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)

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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making126122$0
99284Emergency department visit with moderate level of medical decision making8380$0
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only4845$0
View full utilization report →

Insurance plans in this area (ZIP 47170)

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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: 4385541614View full group profile

Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1609850403 if you need a stable reference for Unknown Individual.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Scottsburg, Indiana for Unknown Individual; download NPPES for the complete set.
What if Scottsburg, Indiana seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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