Unknown Individual – Physician Assistant, NPI 1588641815

Unknown Individual is a healthcare provider. based in Rochester, Minnesota. specializing in Physician Assistant. They hold a License No. 9667 (MN). The NPI Number for Unknown Individual is 1588641815

Main info

Organization
Inactive
25 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1588641815
Phone
(507) 284-2511
Address
200 1ST ST SW
Deactivation Date
24 March 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5072555123
Graduation Year
2001 (25 years ago)
PAC ID
6406986272
Group Practice PAC ID
6507778255
Professional Enrollment ID
I20100605000111

Contacts

Secure Messaging
kpearson139220@ehrdirect.mayoclinicmsg.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness85
Years active:0State licenses:2Other namesUpdated within 12 months

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Provider Addresses for Unknown Individual

  • 1st Street Southwest, Rochester, Olmsted County, Minnesota, 55903, United States

    ROCHESTER, MN 559050001

    Phone: (507) 284-2511

    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.

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

Insurance plans in this area (ZIP 55905)

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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: 6507778255View full group profile

Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1588641815 for Unknown Individual, then check state licensing separately.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Physician Assistant. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Rochester, Minnesota in our summary view.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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