Unknown Individual – Anatomic Pathology & Clinical Pathology Physician, NPI 1154321628

Unknown Individual is a healthcare provider. based in Hiawatha, Kansas. specializing in Anatomic Pathology & Clinical Pathology Physician. They hold a License No. 04-21336 (KS). The NPI Number for Unknown Individual is 1154321628

Main info

Organization
Inactive
43 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1154321628
Phone
(785) 742-2131
Address
300 UTAH ST
Deactivation Date
12 September 2022

Doctor Profile

Medical School Name
UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Secondary Phone
7857422131
Graduation Year
1983 (43 years ago)
PAC ID
4789621350
Professional Enrollment ID
I20050414000875
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

  • Hiawatha Community Hospital, 300, Utah Street, Hiawatha, Brown County, Kansas, 66434, United States

    HIAWATHA, KS 664342314

    Phone: (785) 742-2131

    Type: Location

  • 400, East 10th Street, Interlaken West, Waconia, Carver County, Minnesota, 55387, United States

    WACONIA, MN 553874552

    Phone: (952) 442-9770

    Fax: (952) 442-3620

    Type: Mailing

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.

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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.

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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 66434)

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Provider's Procedures

Unknown Individual performs procedures in Anatomic Pathology & Clinical Pathology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PATHOLOGYKS88304Pathology examination of tissue using a microscope, moderately low complexity3733

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1154321628.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual's primary classification?
Anatomic Pathology & Clinical Pathology Physician is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Hiawatha, Kansas in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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