Unknown Individual – Surgery Physician, NPI 1417955899

Unknown Individual is a healthcare provider. based in Cedar rapids, Iowa. specializing in Surgery Physician. They hold a License No. 34034 (IA). The NPI Number for Unknown Individual is 1417955899

Main info

Organization
Inactive
30 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1417955899
Phone
(319) 398-1583
Address
PO BOX 3178
Deactivation Date
4 January 2023

Doctor Profile

Medical School Name
INDIANA UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
3192473010
Graduation Year
1996 (30 years ago)
PAC ID
9739220989
Group Practice PAC ID
2163325242
Professional Enrollment ID
I20100109000183
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

  • PO BOX 3178

    CEDAR RAPIDS, IA 524063178

    Phone: (319) 398-1583

    Fax: (319) 399-2085

    Type: Mailing

  • Physicians Clinic of Iowa, 202, 10th Street Southeast, MedQuarter, Cedar Rapids, Linn County, Iowa, 52405, United States

    CEDAR RAPIDS, IA 524032404

    Phone: (319) 362-5118

    Fax: (319) 364-0574

    Type: Location

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 52406)

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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: 2163325242View full group profile

Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1417955899.
Is Unknown Individual still active if the NPI shows inactive?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Surgery Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Cedar Rapids, Iowa as the reference point for Unknown Individual, then confirm.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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