Unknown Individual – Surgery Physician, NPI 1366441065

Unknown Individual is a healthcare provider. based in Wichita, Kansas. specializing in Surgery Physician. They hold a License No. 05-26494 (KS). The NPI Number for Unknown Individual is 1366441065

Main info

Organization
Inactive
37 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1366441065
Phone
(316) 685-6222
Address
3243 E MURDOCK
Deactivation Date
5 December 2024

Doctor Profile

Medical School Name
OKLAHOMA STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
3166856222
Graduation Year
1989 (37 years ago)
PAC ID
8325084650
Group Practice PAC ID
8224023445
Professional Enrollment ID
I20050707001031
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • East Murdock Street, Woodlawn Village, Wichita, Sedgwick County, Kansas, 67208, United States

    SUITE 404

    WICHITA, KS 67208

    Phone: (316) 685-6222

    Fax: (316) 685-1273

    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)

CMS reports 1 Open Payments records for all available years, with a total value of $28.

Total Amount is formed as General ($28) + Research ($0) + Ownership ($0) = $28.

Last reported payment date: 2023-05-17 • Largest payer in this snapshot: Haemonetics Corporation ($28).

Total Amount

$28

General + Research + Ownership

Payments

1

Total payment records

General Amount

$28

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-05-17

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Haemonetics Corporation$28
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
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes6243$0
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes2222$0
99223Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes1515$0
View full utilization report →

Insurance plans in this area (ZIP 67208)

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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: 8224023445View full group profile
NameSpecialtyState
Nurse PractitionerKS
General SurgeryKS
General SurgeryKS
General Surgery, Critical Care (Intensivists)KS
General SurgeryKS
Physician AssistantKS
Physician AssistantKS
General SurgeryKS
Physician AssistantKS
Physician AssistantMO

Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1366441065 if you need a stable reference for Unknown Individual.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
What kind of provider is Unknown Individual?
The page reflects Surgery Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Wichita, Kansas because that is what the record indicates for Unknown Individual.
How can I contact Unknown Individual?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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