Unknown Individual – Emergency Medicine Physician, NPI 1356661334

Unknown Individual is a healthcare provider. based in Kalamazoo, Michigan. specializing in Emergency Medicine Physician. They hold a License No. P5373 (TX). The NPI Number for Unknown Individual is 1356661334

Main info

Organization
Inactive
16 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1356661334
Phone
(269) 337-4400
Address
1000 OAKLAND DR
Deactivation Date
20 March 2025

Doctor Profile

Medical School Name
MEDICAL COLLEGE OF WISCONSIN
Secondary Phone
4694205527
Graduation Year
2010 (16 years ago)
PAC ID
8123267531
Group Practice PAC ID
2961830666
Professional Enrollment ID
I20130615000003
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:0State licenses:2Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 1000 OAKLAND DR

    KALAMAZOO, MI 490081282

    Phone: (269) 337-4400

    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)

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making4140$0
99284Emergency department visit with moderate level of medical decision making1717$0
View full utilization report →

Insurance plans in this area (ZIP 49008)

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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: 2961830666View full group profile

Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1356661334 for Unknown Individual.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Kalamazoo, Michigan?
If you are local to Kalamazoo, Michigan, Unknown Individual may be relevant to your search.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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