Unknown Individual – Interventional Cardiology Physician, NPI 1912055112

Unknown Individual is a healthcare provider. based in Lincoln, Nebraska. specializing in Interventional Cardiology Physician. They hold a License No. 27999 (NE). The NPI Number for Unknown Individual is 1912055112

Main info

Organization
Inactive
27 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1912055112
Phone
(402) 413-6363
Address
6940 VAN DORN ST STE 201
Deactivation Date
16 October 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4024144200
Graduation Year
1999 (27 years ago)
PAC ID
9638278716
Group Practice PAC ID
7113282401
Professional Enrollment ID
I20180827003759
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 6940 VAN DORN ST STE 201

    LINCOLN, NE 685062858

    Phone: (402) 413-6363

    Type: Location

  • 310 Sunnyview lane

    Kalispell, MT 59901

    Phone: (406) 752-5111

    Type: Location

  • 6238, South 82nd Street, Parkers Landing 1st Addition, Family Acres, Lincoln, Lancaster County, Nebraska, 68516, United States

    LINCOLN, NE 685166805

    Phone: (847) 305-9599

    Type: Mailing

  • West 86th Street, Sioux Falls, Delapre Township, Lincoln County, South Dakota, 57101, United States

    LINCOLN, NE 68526

    Phone: (402) 414-4200

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 81 Open Payments records for all available years, with a total value of $3,351.

Total Amount is formed as General ($3,351) + Research ($0) + Ownership ($0) = $3,351.

Last reported payment date: 2024-08-20 • Largest payer in this snapshot: Medtronic, Inc. ($2,362).

Total Amount

$3,351

General + Research + Ownership

Payments

81

Total payment records

General Amount

$3,351

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-20

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
Q9967Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml2,52118$0
99214Established patient office or other outpatient visit, 30-39 minutes943537$0
93880Ultrasound of both sides of head and neck blood flow565555$0
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only473324$0
93306Ultrasound of heart with color-depicted blood flow, rate, direction and valve function353343$0
View full utilization report →

Insurance plans in this area (ZIP 68506)

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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: 7113282401View full group profile
NameSpecialtyState
Physician AssistantNE
Cardiovascular Disease (Cardiology), Interventional Cardiology, Cardiovascular Disease (Cardiology), Internal MedicineNE
Nurse PractitionerNE
Nurse PractitionerNE
Nurse PractitionerNE
Cardiovascular Disease (Cardiology)NE

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 1912055112.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Interventional Cardiology Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Lincoln?
Unknown Individual currently maps to Lincoln, Nebraska in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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