Unknown Individual – Family Medicine Physician, NPI 1437117538

Family Medicine Physician

Unknown Individual is a healthcare provider. based in Hibbing, Minnesota. specializing in Family Medicine Physician. They hold a License No. 39450 (MN). The NPI Number for Unknown Individual is 1437117538

Main info

Organization

Inactive

31 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1437117538

Phone

(218) 262-3441

Address

3605 MAYFAIR AVE

Deactivation Date

6 March 2025

Doctor Profile

Medical School Name

UNIVERSITY OF MINNESOTA MEDICAL SCHOOL

Secondary Phone

2188852858

Graduation Year

1995 (31 years ago)

PAC ID

4284716010

Group Practice PAC ID

8022920024

Professional Enrollment ID

I20100325001079

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

3605, Mayfair Avenue, Hibbing, Saint Louis County, Minnesota, 55746, United States
HIBBING, MN 557462923
Phone: (218) 262-3441
Fax: (218) 362-6989
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

HCPCS	Description	Services	Beneficiaries	Medicare allowed
99214	Established patient office or other outpatient visit, 30-39 minutes	130	68	$0
99213	Established patient office or other outpatient visit, 20-29 minutes	65	37	$0
99215	Established patient office or other outpatient visit, 40-54 minutes	25	18	$0

View full utilization report →

Insurance plans in this area (ZIP 55746)

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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: 8022920024View full group profile

Name	Specialty	State
DUSTIN DEAN LUCARELLI (MD)	General Surgery	WI
DAVID CHARLES NAGEL (MD)	-	MN
DR. WENDELL RHETT BONNER (MD)	Family Practice, Emergency Medicine	MN
JANEAN MARIE MCCUE (CNP)	-	MN
REBECCA ANN TERVO (APRN)	Nurse Practitioner	MN
DR. GWEN MINDA COOPER SIMON (MD)	-	AL
JOSHUA LECLAIRE (D.O.)	P A T H O L O G Y	ND
Unknown Individual	-	CA
KATHRYN E. FARNIOK (M.D.)	-	MN
DAVID FROW (MD)	-	OK

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 1437117538.

Is Unknown Individual's NPI deactivated?

The extract indicates Unknown Individual is not in an active NPI state.

What healthcare role does Unknown Individual hold?

Scheduling teams often label Unknown Individual under Family Medicine Physician. Clinical services aligned with this taxonomy classification.

What address line appears for Unknown Individual?

Unknown Individual's geographic hint is Hibbing, Minnesota in our summary view.

What does 'Individual Provider' mean on this profile?

Entity type tells you whether the number belongs to a person or an organization.

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