Unknown Individual – Physician Assistant, NPI 1659818110

Unknown Individual is a healthcare provider. based in Idabel, Oklahoma. specializing in Physician Assistant. They hold a License No. 2759 (OK). The NPI Number for Unknown Individual is 1659818110

Main info

Organization
Inactive
10 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1659818110
Phone
(580) 286-2600
Address
902 E LINCOLN RD
Deactivation Date
29 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9185677000
Graduation Year
2016 (10 years ago)
PAC ID
0648554329
Group Practice PAC ID
1759294838
Professional Enrollment ID
I20170223002268
Data current as of
20 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

  • 902, East Lincoln Road, Idabel, McCurtain County, Oklahoma, 74745, United States

    IDABEL, OK 747457337

    Phone: (580) 286-2600

    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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes138110$0
99214Established patient office or other outpatient visit, 30-39 minutes8770$0
20610Aspiration and/or injection of fluid from large joint6241$0
99215Established patient office or other outpatient visit, 40-54 minutes2825$0
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only1515$0
View full utilization report →

Insurance plans in this area (ZIP 74745)

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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: 1759294838View full group profile
NameSpecialtyState
-TX
-OK
Diagnostic RadiologyOK
Nurse PractitionerOK
N E U R O L O G YAR
E N D O C R I N O L O G YAR
Mental Health CounselorOK
O P T O M E T R YOK
-OK
Interventional Radiology, Diagnostic Radiology, Diagnostic RadiologyOK

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 1659818110.
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 services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Physician Assistant. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Idabel, Oklahoma in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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