Unknown Individual – Emergency Medicine Physician, NPI 1174614796

Unknown Individual is a healthcare provider. based in Saint louis, Missouri. specializing in Emergency Medicine Physician. They hold a License No. 105744 (MO). The NPI Number for Unknown Individual is 1174614796

Main info

Organization
Inactive
35 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1174614796
Phone
(314) 996-5225
Address
660 S EUCLID AVE
Deactivation Date
6 March 2025

Doctor Profile

Medical School Name
UNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE
Secondary Phone
3149669100
Graduation Year
1991 (35 years ago)
PAC ID
7012812514
Group Practice PAC ID
1557366960
Professional Enrollment ID
I20031205000676
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

  • 660, South Euclid Avenue, Central West End, City of Saint Louis, Missouri, 63110, United States

    CB 8072

    SAINT LOUIS, MO 631101010

    Phone: (314) 996-5225

    Fax: (314) 991-0943

    Type: Mailing

  • Missouri Baptist Medical Center, 3015, North Ballas Road, Town and Country, Saint Louis County, Missouri, 63131, United States

    SAINT LOUIS, MO 631312329

    Phone: (314) 996-5225

    Fax: (314) 991-0943

    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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99284Emergency department visit with moderate level of medical decision making9492$0
99285Emergency department visit with high level of medical decision making8379$0
99283Emergency department visit with low level of medical decision making4141$0
View full utilization report →

Insurance plans in this area (ZIP 63110)

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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: 1557366960View full group profile
NameSpecialtyState
Hospitalist, Internal MedicineMO
Internal MedicineMO
-MO
-MO
H O S P I T A L I S TMO
-MO
Internal MedicineMO
Pulmonary Disease, Critical Care (Intensivists), Internal MedicineMO
H O S P I T A L I S TMO
Internal MedicineMO

Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1174614796.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Saint Louis, Missouri; more addresses can appear in NPPES.
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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