Unknown Individual – Pain Medicine (Anesthesiology) Physician, NPI 1164521142

Pain Medicine (Anesthesiology) Physician

Unknown Individual is a healthcare provider. based in Carson city, Nevada. specializing in Pain Medicine (Anesthesiology) Physician. They hold a License No. G57732 (CA). The NPI Number for Unknown Individual is 1164521142

Main info

Organization

Inactive

41 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1164521142

Phone

(775) 783-6190

Address

973 MICA DR

Deactivation Date

24 July 2025

Doctor Profile

Medical School Name

UNIVERSITY OF NEVADA SCHOOL OF MEDICINE

Secondary Phone

7757836190

Graduation Year

1985 (41 years ago)

PAC ID

9133210958

Group Practice PAC ID

8628979267

Professional Enrollment ID

I20070808000789

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

Provider Addresses for Unknown Individual

973 MICA DR
SUITE 201
CARSON CITY, NV 897057255
Phone: (775) 783-6190
Fax: (775) 783-6191
Type: Location
973 MICA DRIVE
SUITE 201
CARSON CITY, NV 897057255
Phone: (775) 783-6190
Fax: (775) 783-6191
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 $15.

Total Amount is formed as General ($15) + Research ($0) + Ownership ($0) = $15.

Last reported payment date: 2023-10-09 • Largest payer in this snapshot: Averitas Pharma Inc. ($15).

Total Amount

$15

General + Research + Ownership

Payments

Total payment records

General Amount

$15

General payments

Research Amount

Research funding

Ownership Amount

Ownership interests

Ownership Count

Ownership records

Last Payment Date

2023-10-09

Latest reported date

Top Companies

Largest payers in this snapshot

Company	Amount
Averitas Pharma Inc.	$15

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 89705)

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Provider's Procedures

Unknown Individual performs procedures in Pain Medicine (Anesthesiology) Physician. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
ANESTHESIOLOGY	NV	20610	Aspiration and/or injection of large joint or joint capsule	27	21
ANESTHESIOLOGY	NV	62311	Injections of substances into lower or sacral spine	191	162

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: 8628979267View full group profile

Name	Specialty	State
DONALD S HUENE (M.D.)	-	NV
MAKENNA PAGE BALACKI (PT, DPT)	-	NV
JAMES P MURPHY (M.D.)	-	NC
JAMES S SOBIEK (M.D.)	-	NV
PAMELA SMITH	-	NV

Reviews

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Frequently asked questions

How do payers reference Unknown Individual?

For Unknown Individual, use NPI 1164521142 as the unique 10-digit identifier.

Does inactive status mean Unknown Individual stopped practicing?

Inactive registry status can reflect deactivation, consolidation, or data lag.

How would a patient describe Unknown Individual's focus?

For Unknown Individual, the primary taxonomy reads as Pain Medicine (Anesthesiology) Physician. Clinical services aligned with this taxonomy classification.

What locale is associated with Unknown Individual?

Directory geography for Unknown Individual centers on Carson City, Nevada.

Can I trust this NPI listing for Unknown Individual?

The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.