Unknown Individual – Cardiovascular Disease Physician, NPI 1548211584

Unknown Individual is a healthcare provider. based in Omaha, Nebraska. specializing in Cardiovascular Disease Physician. They hold a License No. 036.152087 (IL). The NPI Number for Unknown Individual is 1548211584

Main info

Organization
Inactive
41 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1548211584
Phone
(402) 552-2212
Address
4242 Farnam Street
Deactivation Date
25 January 2023

Doctor Profile

Medical School Name
UNIVERSITY OF PUERTO RICO SCHOOL OF MEDICINE
Secondary Phone
5749485340
Graduation Year
1985 (41 years ago)
PAC ID
2365472909
Group Practice PAC ID
8325950843
Professional Enrollment ID
I20200327001020

Contacts

Secure Messaging
jvazquezbauza260994@ewd.direct.hshs.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness85
Years active:0State licenses:4Other namesUpdated within 12 months

Provider Addresses for Unknown Individual

  • 4242 Farnam Street

    Suite 150

    Omaha, NE 681312808

    Phone: (402) 552-2212

    Fax: (402) 552-2205

    Type: Location

  • 2349 Lake Ave Ste 99

    Plymouth, IN 465637837

    Phone: (574) 948-5340

    Type: Location

  • 3003 University Dr

    Marinette, WI 54143

    Phone: (715) 735-8067

    Fax: (715) 732-8224

    Type: Location

  • Saint Anthony's Memorial Hospital, 503, North Maple Street, Effingham, Effingham County, Illinois, 62401, United States

    EFFINGHAM, IL 624012006

    Phone: (217) 342-3700

    Fax: (217) 342-6286

    Type: Mailing

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 68131)

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Provider's Procedures

Unknown Individual performs procedures in Cardiovascular Disease Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
CARDIOVASCULAR DISEASE (CARDIOLOGY)NE78452Nuclear medicine study of vessels of heart using drugs or exercise multiple studies2323

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: 8325950843View full group profile

Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1548211584; it appears in the national provider directory.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
Does Unknown Individual list a primary specialty?
If you are matching referrals, note Cardiovascular Disease Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Omaha, Nebraska because that is what the record indicates for Unknown Individual.
What if Omaha, Nebraska seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.