Unknown Individual – Orthopaedic Surgery Physician, NPI 1982633384

Unknown Individual is a healthcare provider. based in Minneapolis, Minnesota. specializing in Orthopaedic Surgery Physician. They hold a License No. MD195714 (OR). The NPI Number for Unknown Individual is 1982633384

Main info

Organization
Inactive
35 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1982633384
Phone
(612) 338-7697
Address
825 S 8TH ST STE 902
Deactivation Date
6 March 2024

Doctor Profile

Medical School Name
UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Secondary Phone
6123387697
Graduation Year
1991 (35 years ago)
PAC ID
4183715584
Group Practice PAC ID
2668492117
Professional Enrollment ID
I20070814000159

Contacts

Secure Messaging
mwengler187795@samhealth.direct-ci.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness85
Years active:0State licenses:3Other namesUpdated within 12 months

Provider Addresses for Unknown Individual

  • 825 S 8TH ST STE 902

    MINNEAPOLIS, MN 554041220

    Phone: (612) 338-7697

    Fax: (612) 338-3954

    Type: Mailing

  • 675 E Nicollet Blvd

    Suite 250

    Burnsville, MN 553376741

    Phone: (952) 460-4550

    Fax: (952) 460-4551

    Type: Location

  • 825 S 8th St Ste 902

    Minneapolis, MN 554041220

    Phone: (612) 338-7697

    Fax: (612) 338-3954

    Type: Location

  • Samaritan Pacific Communities Hospital, 930, Southwest Abbey Street, Nye Beach, Newport, Lincoln County, Oregon, 97365, United States

    NEWPORT, OR 973654820

    Phone: (541) 574-7235

    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.

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 55404)

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Provider's Procedures

Unknown Individual performs procedures in Orthopaedic Surgery Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
ORTHOPEDIC SURGERYMN73562X-ray of knee, 3 views2016

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: 2668492117View full group profile

Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1982633384 in the public NPI dataset.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Orthopaedic Surgery Physician. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Minneapolis, Minnesota as a primary anchor for Unknown Individual unless the record lists multiple sites.
Why does Unknown Individual have multiple addresses?
4 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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