Unknown Individual – Anesthesiology Physician, NPI 1649387531

Unknown Individual is a healthcare provider. based in Poplar bluff, Missouri. specializing in Anesthesiology Physician. They hold a License No. 2005006158 (MO). The NPI Number for Unknown Individual is 1649387531

Main info

Organization
Inactive
23 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1649387531
Phone
(573) 686-5550
Address
209 S MAIN ST
Deactivation Date
3 July 2025

Doctor Profile

Medical School Name
R FRANKLIN UNIVERSITY OF MED & SCI/CHICAGO MEDICAL SCHOOL
Secondary Phone
5733976556
Graduation Year
2003 (23 years ago)
PAC ID
8527162114
Group Practice PAC ID
4183943384
Professional Enrollment ID
I20070410000034
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

  • 209, South Main Street, Poplar Bluff, Butler County, Missouri, 63901, United States

    POPLAR BLUFF, MO 639015831

    Phone: (573) 686-5550

    Type: Mailing

  • Harry S. Truman Memorial Veterans’ Hospital, 800, Hospital Drive, Columbia, Boone County, Missouri, 65201, United States

    COLUMBIA, MO 652015275

    Phone: (573) 814-6000

    Type: Location

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 $17.

Total Amount is formed as General ($17) + Research ($0) + Ownership ($0) = $17.

Last reported payment date: 2023-02-15 • Largest payer in this snapshot: Rayner Intraocular Lenses Limited ($17).

Total Amount

$17

General + Research + Ownership

Payments

1

Total payment records

General Amount

$17

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-02-15

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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00142Anesthesia for lens surgery797571$0
00145Anesthesia for retinal surgery6666$0
View full utilization report →

Insurance plans in this area (ZIP 63901)

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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: 4183943384View full group profile
NameSpecialtyState
-MO

Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1649387531; it appears in the national provider directory.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Anesthesiology Physician. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Missouri?
You will see Poplar Bluff, Missouri on file for Unknown Individual alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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