Unknown Individual – Diagnostic Radiology Physician, NPI 1235442260

Diagnostic Radiology Physician

Unknown Individual is a healthcare provider. based in Eden prairie, Minnesota. specializing in Diagnostic Radiology Physician. They hold a License No. D81205 (MD). The NPI Number for Unknown Individual is 1235442260

Main info

Organization

Inactive

18 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1235442260

Phone

(952) 595-1301

Address

11995 SINGLETREE LN

Deactivation Date

3 May 2023

Doctor Profile

Medical School Name

UNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE

Secondary Phone

8555044544

Graduation Year

2008 (18 years ago)

PAC ID

5991021057

Group Practice PAC ID

7315841756

Professional Enrollment ID

I20160728000698

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience14

Completeness75

Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

11995 SINGLETREE LN
STE 500
EDEN PRAIRIE, MN 553445347
Phone: (952) 595-1301
Fax: (612) 294-4903
Type: Mailing
11425 DAIRY ST
FULTON, MD 207592662
Phone: (952) 595-1100
Fax: (612) 294-4903
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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55344)

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Provider's Procedures

Unknown Individual performs procedures in Diagnostic Radiology Physician. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
DIAGNOSTIC RADIOLOGY	MD	74177	CT scan of abdomen and pelvis with contrast	16	16

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: 7315841756View full group profile

Name	Specialty	State
DR. LARRY SCOTT KESSLER (MD)	Diagnostic Radiology	MN
EDWARD S OH (M.D.)	Diagnostic Radiology	AZ
RAJESH ANANT BHAVSAR (M.D.)	Diagnostic Radiology	AR
DR. JOHN EDWARD STEWART (MD, PHD)	Nuclear Medicine, Diagnostic Radiology	NC
DR. JOHN TD VU (MD)	Diagnostic Radiology	MO
DR. JOHN MCMAHAN (M.D.)	-	CA
KELLIE D. CURTIS (MD)	Diagnostic Radiology	CA
DR. BRUCE MATTHEWS (M.D.)	-	CA
KARIN L. FU (M.D.)	Diagnostic Radiology	CA
VARTAN MASIHI VARTANIANS (M.D.)	Diagnostic Radiology	CA

Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?

The federal identifier for Unknown Individual is NPI 1235442260.

Why would Unknown Individual's listing show inactive?

Inactive in NPPES means the identifier is not currently active in that dataset.

What does Unknown Individual treat or focus on?

Patients typically see Unknown Individual under the specialty Diagnostic Radiology Physician. Clinical services aligned with this taxonomy classification.

Where does public data place Unknown Individual?

The snapshot lists Eden Prairie, Minnesota for Unknown Individual; download NPPES for the complete set.

How can I contact Unknown Individual?

Phone or fax may appear on the official NPI record when supplied — verify before relying on them.