Unknown Individual – Clinical Neuropsychologist, NPI 1871660035

Unknown Individual is a healthcare provider. based in Mishawaka, Indiana. specializing in Clinical Neuropsychologist. They hold a License No. 20040273A (IN). The NPI Number for Unknown Individual is 1871660035

Main info

Organization
Inactive
40 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1871660035
Phone
(574) 254-9200
Address
135 RED COACH DR
Deactivation Date
27 March 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1986 (40 years ago)
PAC ID
7315041886
Professional Enrollment ID
I20070323000089
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

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Provider Addresses for Unknown Individual

  • 135, Red Coach Drive, Mishawaka, Saint Joseph County, Indiana, 46545, United States

    MISHAWAKA, IN 465453145

    Phone: (574) 254-9200

    Fax: (574) 254-9202

    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
96139Administration of psychological or neuropsychological test by technician, each additional 30 minutes99519$0
90791Psychiatric diagnostic evaluation5555$0
96132Evaluation of neuropsychological test, first hour4040$0
90837Psychotherapy, 1 hour3724$0
96121Exam of neurobehavioral status, each additional hour3619$0
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Insurance plans in this area (ZIP 46545)

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Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1871660035 if you need a stable reference for Unknown Individual.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Clinical Neuropsychologist. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Mishawaka, Indiana because that is what the record indicates for Unknown Individual.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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