Unknown Individual – Pediatric Hematology & Oncology Physician, NPI 1740290402

Unknown Individual is a healthcare provider. based in Reno, Nevada. specializing in Pediatric Hematology & Oncology Physician. They hold a License No. 11300 (NV). The NPI Number for Unknown Individual is 1740290402

Main info

Organization
Inactive
31 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1740290402
Phone
(702) 330-0555
Address
6880 S McCarran Blvd Ste 4
Deactivation Date
6 March 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7023300555
Graduation Year
1995 (31 years ago)
PAC ID
9032148044
Group Practice PAC ID
4688935554
Professional Enrollment ID
I20050810000614
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

Provider Addresses for Unknown Individual

  • 6880 S McCarran Blvd Ste 4

    Reno, NV 895096129

    Phone: (702) 330-0555

    Fax: (702) 832-1128

    Type: Location

  • West Warm Springs Road, Spring Valley, Clark County, Nevada, 89113, United States

    LAS VEGAS, NV 891133629

    Phone: (702) 330-0555

    Fax: (702) 832-1128

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $20.

Total Amount is formed as General ($20) + Research ($0) + Ownership ($0) = $20.

Last reported payment date: 2023-01-20 • Largest payer in this snapshot: Chiesi USA, Inc. ($15).

Total Amount

$20

General + Research + Ownership

Payments

2

Total payment records

General Amount

$20

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-01-20

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.

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

Insurance plans in this area (ZIP 89509)

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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: 4688935554View full group profile
NameSpecialtyState
Pediatric Medicine, Hematology/OncologyNV
Nurse PractitionerNV
H E M A T O L O G YNV

Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1740290402.
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 does the directory say Unknown Individual does?
Insurance directories may phrase it differently, but here Unknown Individual maps to Pediatric Hematology & Oncology Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Reno, Nevada in the same public data insurers reference.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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