Unknown Individual – Urology Physician, NPI 1689649014

Unknown Individual is a healthcare provider. based in Lafayette, Indiana. specializing in Urology Physician. They hold a License No. MD60850740 (WA). The NPI Number for Unknown Individual is 1689649014

Main info

Organization
Inactive
52 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1689649014
Phone
(765) 502-4917
Address
1701 S Creasy Ln
Deactivation Date
16 June 2021

Doctor Profile

Medical School Name
BAYLOR COLLEGE OF MEDICINE
Secondary Phone
7655024000
Graduation Year
1974 (52 years ago)
PAC ID
6406805365
Group Practice PAC ID
3072790682
Professional Enrollment ID
I20190121000460

Contacts

Secure Messaging
jwest408747@Direct.FranciscanAlliance.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness85
Years active:0State licenses:3Other namesUpdated within 12 months

Provider Addresses for Unknown Individual

  • 1701 S Creasy Ln

    Lafayette, IN 47905

    Phone: (765) 502-4917

    Fax: (765) 502-4023

    Type: Location

  • Wenatchee Valley Medical Center, 820, North Chelan Avenue, Wenatchee, Chelan County, Washington, 98801, United States

    WENATCHEE, WA 988012028

    Phone: (509) 663-8711

    Type: Mailing

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.

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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 47905)

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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: 3072790682View full group profile

Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1689649014.
What should I verify if Unknown Individual is listed inactive?
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 Urology Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Lafayette, Indiana?
If you are local to Lafayette, Indiana, Unknown Individual may be relevant to your search.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.