Unknown Individual – Radiation Oncology Physician, NPI 1760474514

Unknown Individual is a healthcare provider. based in Edina, Minnesota. specializing in Radiation Oncology Physician. They hold a License No. 42434 (MN). The NPI Number for Unknown Individual is 1760474514

Main info

Organization
Inactive
29 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1760474514
Phone
(952) 920-4915
Address
MPLS RADIATION ONCOLOGY
Deactivation Date
14 June 2023

Doctor Profile

Medical School Name
DES MOINES UNIVERSITY OF OSTEOPATHIC MEDICINE AND HEALTH SCIENCES
Secondary Phone
9524358668
Graduation Year
1997 (29 years ago)
PAC ID
3274426754
Group Practice PAC ID
8527951094
Professional Enrollment ID
I20080702000604
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

Provider Addresses for Unknown Individual

  • MPLS RADIATION ONCOLOGY

    6950 FRANCE AVE S #200

    EDINA, MN 55435

    Phone: (952) 920-4915

    Fax: (952) 915-6091

    Type: Mailing

  • RIDGE RADIATION THERAPY CTR

    201 E NICOLLET BLVD

    BURNSVILLE, MN 55337

    Phone: (952) 435-8668

    Fax: (952) 435-8659

    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.

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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 55435)

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Provider's Procedures

Unknown Individual performs procedures in Radiation Oncology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
RADIATION ONCOLOGYMN77263Management of radiation therapy, complex2424
RADIATION ONCOLOGYMN77300Calculation of radiation therapy dose8229

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: 8527951094View full group profile
NameSpecialtyState
-MN
Radiation OncologyMN
-MN
Radiation OncologyMN
Radiation OncologyMN
-SD
Radiation OncologyMN
Radiation OncologyMN
Radiation OncologyCA
Radiation OncologyMN

Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1760474514; it appears in the national provider directory.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
What kind of provider is Unknown Individual?
The page reflects Radiation Oncology Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Edina, Minnesota because that is what the record indicates for Unknown Individual.
What if Edina, Minnesota seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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