Unknown Individual – Internal Medicine Physician, NPI 1144205253

Unknown Individual is a healthcare provider. based in Santa fe, New Mexico. specializing in Internal Medicine Physician. They hold a License No. MD2023-1242 (NM). The NPI Number for Unknown Individual is 1144205253

Main info

Organization
Inactive
43 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1144205253
Phone
(505) 955-9454
Address
901 W Alameda St
Deactivation Date
12 March 2026

Doctor Profile

Medical School Name
MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
2568518804
Graduation Year
1983 (43 years ago)
PAC ID
3476677790
Group Practice PAC ID
2668454802
Professional Enrollment ID
I20200625000661
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

  • 901 W Alameda St

    Santa Fe, NM 875011681

    Phone: (505) 955-9454

    Fax: (505) 982-0279

    Type: Location

  • PO BOX 6880

    SANTA FE, NM 875026880

    Phone: (505) 216-0332

    Fax: (505) 982-0279

    Type: Mailing

  • 1691 GALISTEO ST STE D

    SANTA FE, NM 875054781

    Phone: (505) 955-9454

    Fax: (505) 982-0279

    Type: Location

  • Hamill Road, Old Stage Run, Hixson, Chattanooga, Hamilton County, East Tennessee, Tennessee, 37343, United States

    SUITE 103

    HIXSON, TN 373434653

    Phone: (423) 756-8871

    Fax: (423) 475-8976

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $52.

Total Amount is formed as General ($52) + Research ($0) + Ownership ($0) = $52.

Last reported payment date: 2024-05-22 • Largest payer in this snapshot: Exact Sciences Corporation ($36).

Total Amount

$52

General + Research + Ownership

Payments

3

Total payment records

General Amount

$52

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-05-22

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes3836$0
View full utilization report →

Insurance plans in this area (ZIP 87501)

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Provider's Procedures

Unknown Individual performs procedures in Internal Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
INTERNAL MEDICINETN83036Hemoglobin A1C level17669
INTERNAL MEDICINETN90670Pneumococcal vaccine for injection into muscle4343

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: 2668454802View full group profile
NameSpecialtyState
Nurse PractitionerAL
Family PracticeTN
Nurse PractitionerAL
Family PracticeAL
Nurse PractitionerAL
Physician AssistantAL
Family PracticeMD
Family PracticeFL
-AL
O B S T E T R I C S/ G Y N E C O L O G YAL

Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1144205253 if you need a stable reference for Unknown Individual.
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.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Santa Fe, New Mexico for Unknown Individual based on available NPPES addresses.
What if Santa Fe, New Mexico seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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