Unknown Individual – Maternal & Fetal Medicine Physician, NPI 1780684704

Unknown Individual is a healthcare provider. based in Las vegas, Nevada. specializing in Maternal & Fetal Medicine Physician. They hold a License No. 6760 (NV). The NPI Number for Unknown Individual is 1780684704

Main info

Organization
Inactive
40 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1780684704
Phone
(702) 341-6610
Address
5761 S FORT APACHE RD
Deactivation Date
17 January 2022

Doctor Profile

Medical School Name
UNIVERSITY OF NEVADA SCHOOL OF MEDICINE
Secondary Phone
7023416610
Graduation Year
1986 (40 years ago)
PAC ID
6709771702
Group Practice PAC ID
4385645209
Professional Enrollment ID
I20050401000973
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • South Fort Apache Road, Canyon Gate, Las Vegas, Clark County, Nevada, 89145-5800, United States

    BLDG. 8

    LAS VEGAS, NV 891485506

    Phone: (702) 341-6610

    Fax: (702) 341-6961

    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 89148)

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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: 4385645209View full group profile
NameSpecialtyState
Nurse PractitionerHI
-NV
O B S T E T R I C S/ G Y N E C O L O G YNV
Nurse PractitionerNV
O B S T E T R I C S/ G Y N E C O L O G YNV
-NV
O B S T E T R I C S/ G Y N E C O L O G YHI
Undefined Physician Type (Specify)NJ

Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1780684704 for Unknown Individual.
Should I call the clinic if Unknown Individual is inactive here?
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 Maternal & Fetal Medicine Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Las Vegas, Nevada?
If you are local to Las Vegas, 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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