Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1962566018

Unknown Individual is a healthcare provider. based in Jasper, Indiana. specializing in Certified Registered Nurse Anesthetist. They hold a License No. 28113601 (IN). The NPI Number for Unknown Individual is 1962566018

Main info

Organization
Inactive
28 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1962566018
Phone
(812) 996-0643
Address
800 W 9TH ST
Deactivation Date
29 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8129962345
Graduation Year
1998 (28 years ago)
PAC ID
2062304678
Group Practice PAC ID
4587578042
Professional Enrollment ID
I20111028000642
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

  • Memorial Hospital, 800, West 9th Street, Jasper, Dubois County, Indiana, 47546, United States

    JASPER, IN 475462514

    Phone: (812) 996-0643

    Fax: (812) 996-0214

    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
00142Anesthesia for lens surgery248186$0
00812Anesthesia for exam of colon using an endoscope2525$0
00103Anesthesia for procedure on eyelid1615$0
View full utilization report →

Insurance plans in this area (ZIP 47546)

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Provider's Procedures

Unknown Individual performs procedures in Certified Registered Nurse Anesthetist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
CERTIFIED REGISTERED NURSE ANESTHETIN00142Anesthesia for lens surgery136122
CERTIFIED REGISTERED NURSE ANESTHETIN01402Anesthesia for open or endoscopic total knee joint replacement1111

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: 4587578042View full group profile
NameSpecialtyState
Diagnostic RadiologyIN
Family PracticeMI
Medical Oncology, Hematology/OncologyMO
Clinical Social WorkerIN
H E M A T O L O G Y/ O N C O L O G YIN
-IN
A N E S T H E S I O L O G YIN
-IN
Nurse PractitionerIN
Nurse PractitionerIN

Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1962566018?
NPI 1962566018 belongs to Unknown Individual; compare other details if you need extra assurance.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Jasper?
Unknown Individual currently maps to Jasper, Indiana in this extract.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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