Unknown Individual – Urology Physician, NPI 1306824149

Unknown Individual is a healthcare provider. based in Henderson, Nevada. specializing in Urology Physician. They hold a License No. 1668241205 (UT). The NPI Number for Unknown Individual is 1306824149

Main info

Organization
Inactive
46 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1306824149
Phone
(702) 735-8000
Address
9053 S PECOS RD
Deactivation Date
21 November 2024

Doctor Profile

Medical School Name
UNIVERSITY OF UTAH SCHOOL OF MEDICINE
Secondary Phone
7027358000
Graduation Year
1980 (46 years ago)
PAC ID
1951360577
Group Practice PAC ID
5294713335
Professional Enrollment ID
I20041007000678
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • South Pecos Road, Henderson, Clark County, Nevada, 89074, United States

    SUITE 2900

    HENDERSON, NV 890747177

    Phone: (702) 735-8000

    Fax: (702) 735-4795

    Type: Location

  • West Sunset Road, Paradise, Clark County, Nevada, 89119-4016, United States

    SUITE 201A

    LAS VEGAS, NV 891131981

    Phone: (702) 385-4342

    Fax: (702) 385-4346

    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 89074)

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Provider's Procedures

Unknown Individual performs procedures in Urology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
UROLOGYNV55700Biopsy of prostate gland2020
UROLOGYNV76872Ultrasound of rectum2020
UROLOGYNV81002Urinalysis, manual test1518842

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: 5294713335View full group profile
NameSpecialtyState
U R O L O G YNV
Physician AssistantNV
Physician AssistantNV
Physician AssistantCA
U R O L O G YNV
U R O L O G YNV
-NV
U R O L O G YNV
U R O L O G YFL
Physician AssistantNV

Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1306824149.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Urology Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Henderson, Nevada?
If you are local to Henderson, Nevada, Unknown Individual may be relevant to your search.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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