Unknown Individual – Obstetrics & Gynecology Physician, NPI 1912973678

Unknown Individual is a healthcare provider. based in Worthington, Minnesota. specializing in Obstetrics & Gynecology Physician. They hold a License No. 46536 (MN). The NPI Number for Unknown Individual is 1912973678

Main info

Organization
Inactive
48 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1912973678
Phone
(507) 372-3800
Address
1680 DIAGONAL RD
Deactivation Date
9 February 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1978 (48 years ago)
PAC ID
6002706017
Group Practice PAC ID
7810809076
Professional Enrollment ID
I20200623003140
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

  • 1680, Diagonal Road, Worthington, Nobles County, Minnesota, 56187, United States

    WORTHINGTON, MN 561871008

    Phone: (507) 372-3800

    Fax: (507) 372-3806

    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)

CMS reports 1 Open Payments records for all available years, with a total value of $16.

Total Amount is formed as General ($16) + Research ($0) + Ownership ($0) = $16.

Last reported payment date: 2023-02-07 • Largest payer in this snapshot: Boston Scientific Corporation ($16).

Total Amount

$16

General + Research + Ownership

Payments

1

Total payment records

General Amount

$16

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-02-07

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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 56187)

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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: 7810809076View full group profile
NameSpecialtyState
P S Y C H I A T R YIA
Physician AssistantTN
-IA
-PA
Cardiovascular Disease (Cardiology), Critical Care (Intensivists)IA
Certified Registered Nurse Anesthetist (Crna)IA
Physician AssistantIA
-IA
Sleep MedicineIA
Nurse PractitionerIA

Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1912973678.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Obstetrics & Gynecology Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Worthington, Minnesota for Unknown Individual; expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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