Unknown Individual – Specialist, NPI 1629177530

Unknown Individual is a healthcare provider. based in Kearney, Nebraska. specializing in Specialist. They hold a License No. 13732 (NE). The NPI Number for Unknown Individual is 1629177530

Main info

Organization
Inactive
53 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1629177530
Phone
(308) 440-0748
Address
5355 W 85TH ST
Deactivation Date
23 October 2025

Doctor Profile

Medical School Name
UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE
Secondary Phone
4023362611
Graduation Year
1973 (53 years ago)
PAC ID
2567526940
Group Practice PAC ID
4486548203
Professional Enrollment ID
I20090129000455
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 5355 W 85TH ST

    KEARNEY, NE 688451422

    Phone: (308) 440-0748

    Type: Mailing

  • 3015, Avenue A, Kearney, Buffalo County, Nebraska, 68847, United States

    KEARNEY, NE 688473525

    Phone: (308) 865-2565

    Fax: (308) 865-2569

    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 68845)

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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: 4486548203View full group profile
NameSpecialtyState
Internal MedicineNE
Physician AssistantNE
Family PracticeNE
Certified Registered Nurse Anesthetist (Crna)IA
Nurse PractitionerNE
Nurse PractitionerNE
Family PracticeNE
Physician AssistantNE
General SurgeryNE
Nurse PractitionerNE

Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1629177530; it appears in the national provider directory.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
Does Unknown Individual list a primary specialty?
If you are matching referrals, note Other Service Providers for Unknown Individual. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Nebraska?
You will see Kearney, Nebraska on file for Unknown Individual alongside any extra practice locations.
How can I contact Unknown Individual?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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MED-CARE, INC

Specialist
603 N DIERS AVENUE
NPI: 1881985646