Unknown Individual – Allergy Physician, NPI 1598756157

Unknown Individual is a healthcare provider. based in Maplewood, Minnesota. specializing in Allergy Physician. They hold a License No. 45733 (MN). The NPI Number for Unknown Individual is 1598756157

Main info

Organization
Inactive
26 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1598756157
Phone
(651) 326-1044
Address
3100 KENNARD ST
Deactivation Date
20 September 2023

Doctor Profile

Medical School Name
UNIVERSITY OF IOWA, RJ & L CARVER COLLEGE OF MEDICINE
Secondary Phone
6512327800
Graduation Year
2000 (26 years ago)
PAC ID
2567593882
Group Practice PAC ID
3971407636
Professional Enrollment ID
I20100701000153
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

  • 3100, Kennard Street, Maplewood, Ramsey County, Minnesota, 55109, United States

    MAPLEWOOD, MN 551095439

    Phone: (651) 326-1044

    Fax: (651) 326-1089

    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 55109)

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Provider's Procedures

Unknown Individual performs procedures in Allergy Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
ALLERGY/IMMUNOLOGYMN95004Injection of allergenic extracts into skin, accessed through the skin53219
ALLERGY/IMMUNOLOGYMN95117Injection of incremental dosages of allergen, 2 or more injections17512

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: 3971407636View 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 1598756157 for Unknown Individual, then check state licensing separately.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Allergy Physician. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Maplewood, Minnesota may find Unknown Individual in results; validate coverage separately.
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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