Unknown Individual – Family Medicine Physician, NPI 1063408870

Unknown Individual is a healthcare provider. based in Newton, Iowa. specializing in Family Medicine Physician. They hold a License No. 1090 (IA). The NPI Number for Unknown Individual is 1063408870

Main info

Organization
Inactive
51 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1063408870
Phone
(641) 792-7640
Address
321 E 3RD ST N
Deactivation Date
26 July 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3195243185
Graduation Year
1975 (51 years ago)
PAC ID
5496753899
Group Practice PAC ID
8022912211
Professional Enrollment ID
I20061120000084
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

  • 321, East 3rd Street North, Newton, Jasper County, Iowa, 50208, United States

    NEWTON, IA 502083210

    Phone: (641) 792-7640

    Fax: (641) 792-4029

    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
96127Assessment of emotional or behavioral problems17955$0
Q3014Telehealth originating site facility fee8146$0
99214Established patient office or other outpatient visit, 30-39 minutes6139$0
99215Established patient office or other outpatient visit, 40-54 minutes3727$0
View full utilization report →

Insurance plans in this area (ZIP 50208)

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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: 8022912211View full group profile
NameSpecialtyState
Mental Health CounselorIA
Mental Health CounselorIA
Nurse PractitionerIA
Nurse PractitionerIA
-IA
Mental Health CounselorIA
Nurse PractitionerIA
Mental Health CounselorIA
Nurse PractitionerIA
Nurse PractitionerIA

Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1063408870.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
How should patients interpret Unknown Individual's specialty?
The extract shows Family Medicine Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Newton, Iowa?
If you are local to Newton, Iowa, Unknown Individual may be relevant to your search.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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