Unknown Individual – Physical Therapist, NPI 1619971033

Unknown Individual is a healthcare provider. based in South bend, Indiana. specializing in Physical Therapist. They hold a License No. 05001955A (IN). The NPI Number for Unknown Individual is 1619971033

Main info

Organization
Inactive
50 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1619971033
Phone
(574) 231-1389
Address
6450 MIAMI CIR
Deactivation Date
7 August 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5742479441
Graduation Year
1976 (50 years ago)
PAC ID
2860305877
Group Practice PAC ID
7618234121
Professional Enrollment ID
I20070502000524
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

Provider Addresses for Unknown Individual

  • 6450 MIAMI CIR

    SOUTH BEND, IN 466146480

    Phone: (574) 231-1389

    Fax: (574) 231-1502

    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
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes740151$0
97140Therapy procedure using manual technique, each 15 minutes25785$0
97530Therapy procedure using functional activities21378$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes5523$0
97162Evaluation for physical therapy, typically 30 minutes2020$0
View full utilization report →

Insurance plans in this area (ZIP 46614)

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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: 7618234121View 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 1619971033.
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.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Physical Therapist in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with South Bend, Indiana. Check all listed addresses for suites or satellite offices.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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