Unknown Individual – Surgery Physician, NPI 1063498855

Unknown Individual is a healthcare provider. based in Muscatine, Iowa. specializing in Surgery Physician. They hold a License No. MD-26048 (IA). The NPI Number for Unknown Individual is 1063498855

Main info

Organization
Inactive
40 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1063498855
Phone
(563) 262-4112
Address
1518 MULBERRY AVE
Deactivation Date
27 November 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3192725000
Graduation Year
1986 (40 years ago)
PAC ID
7012907223
Group Practice PAC ID
0244148732
Professional Enrollment ID
I20040518000379
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Trinity Muscatine Hospital, 1518, Mulberry Avenue, Muscatine, Muscatine County, Iowa, 52761, United States

    MUSCATINE, IA 527613433

    Phone: (563) 262-4112

    Type: Location

  • 1518 Mulberry Ave

    Muscatine, IA 527613433

    Phone: (563) 262-4112

    Type: Location

  • 2710 SAINT FRANCIS DR STE 410

    WATERLOO, IA 507025634

    Phone: (319) 272-5000

    Fax: (319) 272-5206

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 12 Open Payments records for all available years, with a total value of $814.

Total Amount is formed as General ($814) + Research ($0) + Ownership ($0) = $814.

Last reported payment date: 2024-10-10 • Largest payer in this snapshot: Integra LifeSciences Corporation ($550).

Total Amount

$814

General + Research + Ownership

Payments

12

Total payment records

General Amount

$814

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-10

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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
99213Established patient office or other outpatient visit, 20-29 minutes5340$0
99203New patient office or other outpatient visit, 30-44 minutes5252$0
99231Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes4220$0
11042Removal of skin and tissue, 20.0 sq cm or less3414$0
99212Established patient office or other outpatient visit, 10-19 minutes2219$0
View full utilization report →

Insurance plans in this area (ZIP 52761)

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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: 0244148732View full group profile
NameSpecialtyState
-IA
Gastroenterology, Internal MedicineIA
Nurse PractitionerIA
Nurse PractitionerIA
Physician AssistantIA
-IN
Orthopedic SurgeryIA
Family PracticeIA
Family PracticeIA
Nurse PractitionerIA

Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1063498855 on file in the registry.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Surgery Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Muscatine?
Public fields place Unknown Individual around Muscatine, Iowa. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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