Unknown Individual – Surgery Physician, NPI 1598764425

Unknown Individual is a healthcare provider. based in Saint louis, Missouri. specializing in Surgery Physician. They hold a License No. 110449 (MO). The NPI Number for Unknown Individual is 1598764425

Main info

Organization
Inactive
30 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1598764425
Phone
(314) 525-1224
Address
10012 KENNERLY RD
Deactivation Date
13 March 2025

Doctor Profile

Medical School Name
ILLINOIS MEDICAL COLLEGE
Secondary Phone
-
Graduation Year
1996 (30 years ago)
PAC ID
6204895279
Group Practice PAC ID
2466351093
Professional Enrollment ID
I20130830000499

Contacts

Secure Messaging
eng99612@soc.inova.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience33
Completeness85
Years active:0State licenses:2Other namesUpdated within 12 months

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Provider Addresses for Unknown Individual

  • 10012, Kennerly Road, Sappington, Saint Louis County, Missouri, 63128, United States

    SUITE 406

    SAINT LOUIS, MO 631282197

    Phone: (314) 525-1224

    Fax: (314) 525-4957

    Type: Mailing

  • 10012 Kennerly Rd

    Suite 406

    Saint Louis, MO 631282197

    Phone: (314) 525-1224

    Fax: (314) 525-4957

    Type: Location

  • 6565 Arlington Blvd Ste 500

    Falls Church, VA 220423018

    Phone: (703) 531-2246

    Fax: (703) 237-7895

    Type: Location

  • 3300 Gallows Rd

    Falls Church, VA 220423307

    Phone: (703) 776-4001

    Fax: (703) 776-7113

    Type: Location

  • PO BOX 37174

    BALTIMORE, MD 212973174

    Phone: (571) 423-5699

    Fax: (571) 423-5698

    Type: Mailing

  • 3300 GALLOWS RD

    FALLS CHURCH, VA 220423307

    Phone: (703) 776-4001

    Fax: (703) 776-7113

    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
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes214122$0
99223Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes5959$0
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes4949$0
99238Hospital discharge day management, 30 minutes or less4444$0
99231Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes3416$0
View full utilization report →

Insurance plans in this area (ZIP 63128)

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Provider's Procedures

Unknown Individual performs procedures in Surgery Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
GENERAL SURGERYMO36620Insertion of arterial catheter for blood sampling or infusion, accessed through the skin1111

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: 2466351093View full group profile

Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1598764425 for Unknown Individual.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Surgery Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Saint Louis, Missouri in the same public data insurers reference.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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