Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1942267307

Unknown Individual is a healthcare provider. based in Ann arbor, Michigan. specializing in Certified Registered Nurse Anesthetist. They hold a License No. 4704177614 (MI). The NPI Number for Unknown Individual is 1942267307

Main info

Organization
Inactive
42 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1942267307
Phone
(734) 936-2047
Address
3621 S STATE ST
Deactivation Date
23 October 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2394818833
Graduation Year
1984 (42 years ago)
PAC ID
9638111941
Group Practice PAC ID
2668773615
Professional Enrollment ID
I20180118000590
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

  • South State Street, Ann Arbor, Washtenaw County, Michigan, 48108-1774, United States

    700 KMS PLACE

    ANN ARBOR, MI 48108

    Phone: (734) 936-2047

    Type: Mailing

  • Mott Children's Hospital and Von Voigtlander Women's Hospital, 1500, East Medical Center Drive, Ann Arbor, Washtenaw County, Michigan, 48109, United States

    ANN ARBOR, MI 481090048

    Phone: (734) 936-4280

    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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00142Anesthesia for lens surgery123113$0
View full utilization report →

Insurance plans in this area (ZIP 48108)

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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: 2668773615View full group profile

Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1942267307.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Ann Arbor, Michigan for Unknown Individual based on available NPPES addresses.
What if Ann Arbor, Michigan seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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