Unknown Individual – Specialist, NPI 1205870599

Unknown Individual is a healthcare provider. based in Jackson, Michigan. specializing in Specialist. They hold a License No. MD018116 (LA). The NPI Number for Unknown Individual is 1205870599

Main info

Organization
Inactive
45 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1205870599
Phone
(517) 787-6440
Address
744 W MICHIGAN AVE
Deactivation Date
8 May 2025

Doctor Profile

Medical School Name
PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
5046130711
Graduation Year
1981 (45 years ago)
PAC ID
1658372214
Group Practice PAC ID
0446152862
Professional Enrollment ID
I20070124000656
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

  • 744, West Michigan Avenue, Jackson, Jackson County, Michigan, 49201, United States

    JACKSON, MI 492011909

    Phone: (517) 787-6440

    Fax: (517) 787-4146

    Type: Mailing

  • North Causeway Boulevard, Metairie, Jefferson Parish, Louisiana, 70001, United States

    SUITE 404

    METAIRIE, LA 700023531

    Phone: (504) 779-5515

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $58.

Total Amount is formed as General ($58) + Research ($0) + Ownership ($0) = $58.

Last reported payment date: 2024-02-01 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($39).

Total Amount

$58

General + Research + Ownership

Payments

3

Total payment records

General Amount

$58

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-02-01

Latest reported date

Top Companies

Largest payers in this snapshot

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
36620Insertion of artery tube for blood sampling or infusion through skin3332$0
76937Ultrasonic guidance for blood vessel access2928$0
64447Injection of anesthetic agent and/or steroid into thigh nerve (femoral nerve)1313$0
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Insurance plans in this area (ZIP 49201)

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Provider's Procedures

Unknown Individual performs procedures in Specialist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
ANESTHESIOLOGYLA01402Anesthesia for open or endoscopic total knee joint replacement1414

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: 0446152862View full group profile
NameSpecialtyState
-MI
Certified Registered Nurse Anesthetist (Crna)LA
-LA
Certified Registered Nurse Anesthetist (Crna)LA
Certified Registered Nurse Anesthetist (Crna)LA
Certified Registered Nurse Anesthetist (Crna)LA
Certified Registered Nurse Anesthetist (Crna)LA
Certified Registered Nurse Anesthetist (Crna)LA
Certified Registered Nurse Anesthetist (Crna)LA
A N E S T H E S I O L O G YLA

Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1205870599.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual's primary classification?
Other Service Providers is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Jackson, Michigan as a primary anchor for Unknown Individual unless the record lists multiple sites.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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