Unknown Individual – Surgery Physician, NPI 1871587295

Unknown Individual is a healthcare provider. based in Goshen, Indiana. specializing in Surgery Physician. They hold a License No. 01038469 (IN). The NPI Number for Unknown Individual is 1871587295

Main info

Organization
Inactive
42 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1871587295
Phone
(574) 535-9100
Address
2006 S MAIN ST
Deactivation Date
28 April 2025

Doctor Profile

Medical School Name
INDIANA UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
5745359100
Graduation Year
1984 (42 years ago)
PAC ID
5092848952
Group Practice PAC ID
6406835941
Professional Enrollment ID
I20100729000821

Contacts

Secure Messaging
clinical@gsa.directbygreeway.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness85
Years active:0State licenses:1Other namesUpdated within 12 months

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Provider Addresses for Unknown Individual

  • 2006, South Main Street, Historic Racemere Peninsula, Goshen, Elkhart County, Indiana, 46526, United States

    SUITE A

    GOSHEN, IN 465265232

    Phone: (574) 535-9100

    Fax: (574) 535-1020

    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 46526)

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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: 6406835941View full group profile
NameSpecialtyState
-IN
Physician AssistantIN
General SurgeryIN
Nurse PractitionerIN
General SurgeryIN
General SurgeryIN
General SurgeryIN
-IN

Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1871587295.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Surgery Physician. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Goshen, Indiana?
For routing, start with Goshen, Indiana for Unknown Individual, then verify phone and hours locally.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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