Unknown Individual – Geriatric Medicine (Family Medicine) Physician, NPI 1891871026

Unknown Individual is a healthcare provider. based in Highland, Indiana. specializing in Geriatric Medicine (Family Medicine) Physician. They hold a License No. 01026043 (IN). The NPI Number for Unknown Individual is 1891871026

Main info

Organization
Inactive
58 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1891871026
Phone
(219) 838-0066
Address
2914 HIGHWAY AVE
Deactivation Date
14 June 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2196711298
Graduation Year
1968 (58 years ago)
PAC ID
8820982176
Group Practice PAC ID
9739476201
Professional Enrollment ID
I20090630000325
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

  • 2914, Highway Avenue, Orchard Park, Highland, Lake County, Indiana, 46322, United States

    HIGHLAND, IN 463221656

    Phone: (219) 838-0066

    Fax: (219) 838-4096

    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 46322)

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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: 9739476201View full group profile
NameSpecialtyState
Nurse PractitionerIL
-WI
Internal Medicine, Emergency MedicineIN
P S Y C H I A T R YIN
-IN
-NE
Nurse PractitionerIL
Psychiatry, Internal MedicineIL
Physician AssistantIN
Nurse PractitionerIN

Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1891871026.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What kind of provider is Unknown Individual?
The page reflects Geriatric Medicine (Family Medicine) Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Highland, 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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