Unknown Individual – Infectious Disease Physician, NPI 1407830425

Unknown Individual is a healthcare provider. based in Las vegas, Nevada. specializing in Infectious Disease Physician. They hold a License No. 4579 (NV). The NPI Number for Unknown Individual is 1407830425

Main info

Organization
Inactive
56 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1407830425
Phone
(702) 737-0740
Address
3006 S MARYLAND PKWY
Deactivation Date
24 May 2022

Doctor Profile

Medical School Name
UNIVERSITY OF CHICAGO, PRITZKER SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
1970 (56 years ago)
PAC ID
7416138755
Professional Enrollment ID
I20110221000353
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

  • South Maryland Parkway, Downtown Las Vegas, Las Vegas, Clark County, Nevada, 89101, United States

    SUITE 780

    LAS VEGAS, NV 891092218

    Phone: (702) 737-0740

    Fax: (702) 737-1402

    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)

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 89109)

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Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1407830425.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Infectious Disease Physician. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Las Vegas, Nevada for Unknown Individual based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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