Unknown Individual – Interventional Cardiology Physician, NPI 1720038300

Unknown Individual is a healthcare provider. based in Columbia, Missouri. specializing in Interventional Cardiology Physician. They hold a License No. MD100191 (MO). The NPI Number for Unknown Individual is 1720038300

Main info

Organization
Inactive
48 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1720038300
Phone
(573) 882-2296
Address
1 HOSPITAL DR
Deactivation Date
22 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5738759000
Graduation Year
1978 (48 years ago)
PAC ID
2264539691
Group Practice PAC ID
4486759560
Professional Enrollment ID
I20070521000219

Contacts

Secure Messaging
MUDOCREFERRAL@direct.health.missouri.edu
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

Provider Addresses for Unknown Individual

  • 1 HOSPITAL DR

    COLUMBIA, MO 652120001

    Phone: (573) 882-2296

    Fax: (573) 884-7743

    Type: Location

  • Columbia Post Office, 6801, Oak Hall Lane, Howard County, Maryland, 21045, United States

    COLUMBIA, MO 652057687

    Phone: (573) 882-2259

    Type: Mailing

  • Hospital Drive, Columbia, Boone County, Missouri, 65212, United States

    COLUMBIA, MO 652120001

    Phone: (573) 882-2296

    Fax: (573) 884-7743

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $83.

Total Amount is formed as General ($83) + Research ($0) + Ownership ($0) = $83.

Last reported payment date: 2023-09-19 • Largest payer in this snapshot: Medtronic, Inc. ($47).

Total Amount

$83

General + Research + Ownership

Payments

3

Total payment records

General Amount

$83

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-09-19

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
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only1,6391,230$0
93306Ultrasound of heart with color-depicted blood flow, rate, direction and valve function183183$0
93308Ultrasound of heart, follow-up4240$0
93325Ultrasound of heart with color-depicted blood flow, rate and valve function3331$0
93321Ultrasound of heart blood flow, valves and chambers, follow-up2423$0
View full utilization report →

Insurance plans in this area (ZIP 65212)

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Provider's Procedures

Unknown Individual performs procedures in Interventional Cardiology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
CARDIOVASCULAR DISEASE (CARDIOLOGY)MO93010Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report19371462

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: 4486759560View full group profile
NameSpecialtyState
H E M A T O L O G Y/ O N C O L O G YPA
General SurgeryMO
Family PracticeMO
Psychiatry, NeurologyMO
-MO
-MO
-OH
Family PracticeMO
-WA
Diagnostic RadiologyMO

Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1720038300.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Interventional Cardiology Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Columbia?
Public fields place Unknown Individual around Columbia, Missouri. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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