Unknown Individual – Otolaryngology Physician, NPI 1982683900

Unknown Individual is a healthcare provider. based in Mankato, Minnesota. specializing in Otolaryngology Physician. They hold a License No. 40897 (MN). The NPI Number for Unknown Individual is 1982683900

Main info

Organization
Inactive
33 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1982683900
Phone
(507) 625-1811
Address
1230 E MAIN ST
Deactivation Date
1 May 2025

Doctor Profile

Medical School Name
UNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE
Secondary Phone
5073866750
Graduation Year
1993 (33 years ago)
PAC ID
9133261621
Group Practice PAC ID
5597677955
Professional Enrollment ID
I20100222000861

Contacts

Secure Messaging
timothychristiansen@mklt.allscriptsdirect.net
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness85
Years active:0State licenses:1Other namesUpdated within 12 months

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Provider Addresses for Unknown Individual

  • Mankato Clinic, 1230, East Main Street, High Ciara, Mankato, Blue Earth County, Minnesota, 56001, United States

    PO BOX 8674

    MANKATO, MN 560028674

    Phone: (507) 625-1811

    Type: Mailing

  • 1421, Premier Dr, Mankato, Blue Earth County, Minnesota, 56001, United States

    MANKATO CLINIC @ WICKERSHAM CAMPUS

    MANKATO, MN 56001

    Phone: (507) 625-1811

    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 56002)

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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: 5597677955View full group profile
NameSpecialtyState
Physician AssistantMN
Nurse PractitionerMN
-MN
Diagnostic RadiologyCO
Physician AssistantMN
P O D I A T R YMN
-MN
-MN
General SurgeryMN
Diagnostic Radiology, Internal MedicineMN

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 1982683900 in the public NPI dataset.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Otolaryngology Physician in this dataset. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Mankato, Minnesota may find Unknown Individual in results; validate coverage separately.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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