Unknown Individual – Diagnostic Radiology Physician, NPI 1669407763

Unknown Individual is a healthcare provider. based in Albuquerque, New Mexico. specializing in Diagnostic Radiology Physician. They hold a License No. 200076 (NM). The NPI Number for Unknown Individual is 1669407763

Main info

Organization
Inactive
29 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1669407763
Phone
(505) 232-1920
Address
PO BOX 27829
Deactivation Date
20 March 2025

Doctor Profile

Medical School Name
PENNSYLVANIA STATE UNIVERSITY COLLEGE OF MEDICINE
Secondary Phone
8552921401
Graduation Year
1997 (29 years ago)
PAC ID
6204893118
Group Practice PAC ID
0244368868
Professional Enrollment ID
I20041213000503
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

  • PO BOX 27829

    ALBUQUERQUE, NM 87125

    Phone: (505) 232-1920

    Fax: (505) 727-9276

    Type: Mailing

  • Quality Inn & Suites Albuquerque - Gibson Blvd, Gibson Boulevard Southeast, Albuquerque, Bernalillo County, New Mexico, 87106, United States

    ALBUQUERQUE, NM 87108

    Phone: (505) 262-7000

    Type: Location

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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
71045X-ray of chest, 1 view708678$0
70450Ct scan head or brain without contrast356348$0
74177Ct scan of abdomen and pelvis with contrast154151$0
74176Ct scan of abdomen and pelvis without contrast114111$0
72125Ct scan of upper spine without contrast9696$0
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Insurance plans in this area (ZIP 87125)

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Provider's Procedures

Unknown Individual performs procedures in Diagnostic Radiology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DIAGNOSTIC RADIOLOGYNM71250CT scan chest149145
DIAGNOSTIC RADIOLOGYNM73110X-ray of wrist, minimum of 3 views10676
DIAGNOSTIC RADIOLOGYNM73140X-ray of fingers, minimum of 2 views6048
DIAGNOSTIC RADIOLOGYNM73562X-ray of knee, 3 views7063
DIAGNOSTIC RADIOLOGYNM73630X-ray of foot, minimum of 3 views137114
DIAGNOSTIC RADIOLOGYNM74177CT scan of abdomen and pelvis with contrast3131
DIAGNOSTIC RADIOLOGYNM76830Ultrasound pelvis through vagina3027

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: 0244368868View full group profile

Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1669407763.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Diagnostic Radiology Physician. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Albuquerque, New Mexico in our summary view.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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