Unknown Individual – Family Medicine Physician, NPI 1720079411

Unknown Individual is a healthcare provider. based in Newburgh, Indiana. specializing in Family Medicine Physician. They hold a License No. 01038885 (IN). The NPI Number for Unknown Individual is 1720079411

Main info

Organization
Inactive
37 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1720079411
Phone
(812) 490-5126
Address
8080 HIGH POINTE DR
Deactivation Date
2 December 2020

Doctor Profile

Medical School Name
INDIANA UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
1989 (37 years ago)
PAC ID
5193798965
Professional Enrollment ID
I20040818001394
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

  • 8080 HIGH POINTE DR

    NEWBURGH, IN 476303026

    Phone: (812) 490-5126

    Fax: (812) 490-5127

    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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 47630)

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Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1720079411?
NPI 1720079411 belongs to Unknown Individual; compare other details if you need extra assurance.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Family Medicine Physician in the directory — Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Newburgh?
Public fields place Unknown Individual around Newburgh, Indiana. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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