Unknown Individual – Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician, NPI 1043215890

Unknown Individual is a healthcare provider. based in Oklahoma city, Oklahoma. specializing in Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician. They hold a License No. 10891 (OK). The NPI Number for Unknown Individual is 1043215890

Main info

Organization
Inactive
51 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1043215890
Phone
(405) 951-4345
Address
3433 NW 56TH ST
Deactivation Date
28 November 2024

Doctor Profile

Medical School Name
UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
Secondary Phone
4059514345
Graduation Year
1975 (51 years ago)
PAC ID
0042200206
Group Practice PAC ID
3577730068
Professional Enrollment ID
I20040518000649
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 3433, Northwest 56th Street, Oklahoma City, Oklahoma County, Oklahoma, 73112, United States

    STE 760

    OKLAHOMA CITY, OK 731124430

    Phone: (405) 951-4345

    Fax: (405) 951-4392

    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)

CMS reports 9 Open Payments records for all available years, with a total value of $229.

Total Amount is formed as General ($229) + Research ($0) + Ownership ($0) = $229.

Last reported payment date: 2024-07-11 • Largest payer in this snapshot: Corcym Inc ($101).

Total Amount

$229

General + Research + Ownership

Payments

9

Total payment records

General Amount

$229

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-07-11

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 73112)

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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: 3577730068View full group profile
NameSpecialtyState
Pulmonary DiseaseTN
Cardiac Electrophysiology, Cardiovascular Disease (Cardiology)OK
Nurse PractitionerOK
Physician AssistantOK
Interventional Cardiology, Cardiovascular Disease (Cardiology), Internal MedicineOK
Nurse PractitionerOK
Vascular SurgeryOK
Physician AssistantOK
-OK
-OK

Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1043215890.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Oklahoma City?
Unknown Individual currently maps to Oklahoma City, Oklahoma in this extract.
Can I trust this NPI listing for Unknown Individual?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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