Unknown Individual – Cardiovascular Disease Physician, NPI 1245229400

Unknown Individual is a healthcare provider. based in Las vegas, Nevada. specializing in Cardiovascular Disease Physician. They hold a License No. 3519 (NV). The NPI Number for Unknown Individual is 1245229400

Main info

Organization
Inactive
58 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1245229400
Phone
(702) 384-0022
Address
700 SHADOW LN
Deactivation Date
21 June 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7026429010
Graduation Year
1968 (58 years ago)
PAC ID
3072414739
Group Practice PAC ID
0042111825
Professional Enrollment ID
I20101027000222
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 700, Shadow Lane, Las Vegas, Clark County, Nevada, 89106, United States

    SUITE 240

    LAS VEGAS, NV 891064158

    Phone: (702) 384-0022

    Fax: (702) 384-0529

    Mailing address matches the actual address.

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 $23.

Total Amount is formed as General ($23) + Research ($0) + Ownership ($0) = $23.

Last reported payment date: 2023-04-03 • Largest payer in this snapshot: PFIZER INC. ($23).

Total Amount

$23

General + Research + Ownership

Payments

1

Total payment records

General Amount

$23

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-04-03

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
PFIZER INC.$23
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
99214Established patient office or other outpatient visit, 30-39 minutes2424$0
93000Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report1212$0
View full utilization report →

Insurance plans in this area (ZIP 89106)

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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)NV78452Nuclear medicine study of vessels of heart using drugs or exercise multiple studies258254
CARDIOVASCULAR DISEASE (CARDIOLOGY)NV93280Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report4726

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: 0042111825View full group profile
NameSpecialtyState
Cardiovascular Disease (Cardiology)NV
Cardiovascular Disease (Cardiology)MI
Cardiovascular Disease (Cardiology)NV
Cardiovascular Disease (Cardiology)NV
Cardiovascular Disease (Cardiology), Interventional CardiologyKY
Internal Medicine, Cardiovascular Disease (Cardiology)NV
Cardiovascular Disease (Cardiology)NV
Cardiovascular Disease (Cardiology)NV
Cardiovascular Disease (Cardiology)NV
Interventional CardiologyNV

Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1245229400.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Cardiovascular Disease Physician. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Las Vegas, Nevada in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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