Unknown Individual – Neurology Physician, NPI 1417951443

Unknown Individual is a healthcare provider. based in Minneapolis, Minnesota. specializing in Neurology Physician. They hold a License No. 22836 (MN). The NPI Number for Unknown Individual is 1417951443

Main info

Organization
Inactive
51 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1417951443
Phone
(612) 879-1000
Address
2828 CHICAGO AVE
Deactivation Date
13 September 2023

Doctor Profile

Medical School Name
UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Secondary Phone
6128791000
Graduation Year
1975 (51 years ago)
PAC ID
8325932759
Group Practice PAC ID
3971497389
Professional Enrollment ID
I20100828000097
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

  • Chicago Av, East Franklin Avenue, Phillips, Minneapolis, Hennepin County, Minnesota, 55404, United States

    STE 200

    MINNEAPOLIS, MN 554071544

    Phone: (612) 879-1000

    Fax: (612) 879-9116

    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
99214Established patient office or other outpatient visit, 30-39 minutes2827$0
99213Established patient office or other outpatient visit, 20-29 minutes1717$0
View full utilization report →

Insurance plans in this area (ZIP 55407)

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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: 3971497389View full group profile
NameSpecialtyState
Nurse PractitionerMN
N E U R O L O G YMN
-MN
N E U R O L O G YMN
N E U R O L O G YMN
Neurology, Neuropsychiatry, Pain Management, Interventional Pain ManagementMN
N E U R O L O G YMN
Sleep Medicine, NeurologyMN
-MN
-MN

Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1417951443.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Neurology Physician. Clinical services aligned with this taxonomy classification.
Where in Minnesota is Unknown Individual registered?
Use Minneapolis, Minnesota as the headline location for Unknown Individual here.
Can I trust this NPI listing for Unknown Individual?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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