Unknown Individual – Physical Therapist, NPI 1063893881

Unknown Individual is a healthcare provider. based in Eugene, Oregon. specializing in Physical Therapist. They hold a License No. 61129 (OR). The NPI Number for Unknown Individual is 1063893881

Main info

Organization
Inactive
11 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1063893881
Phone
(802) 558-4199
Address
771 RIVER RD
Deactivation Date
8 May 2025

Doctor Profile

Medical School Name
UNIVERSITY OF VERMONT COLLEGE OF MEDICINE
Secondary Phone
8028601358
Graduation Year
2015 (11 years ago)
PAC ID
0042529166
Group Practice PAC ID
2163442138
Professional Enrollment ID
I20161215000672
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

Provider Addresses for Unknown Individual

  • 771 RIVER RD

    EUGENE, OR 974043213

    Phone: (802) 558-4199

    Type: Mailing

  • 680 IVY ST

    JUNCTION CITY, OR 974481636

    Phone: (541) 998-9988

    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
97140Therapy procedure using manual technique, each 15 minutes15215$0
View full utilization report →

Insurance plans in this area (ZIP 97404)

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Provider's Procedures

Unknown Individual performs procedures in Physical Therapist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYOR97001Physical therapy evaluation2725

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: 2163442138View full group profile
NameSpecialtyState
-VT
-VT
Physical Therapist In Private PracticeVT
Physical Therapist In Private PracticeVT
Physical Therapist In Private PracticeVT
Physical Therapist In Private PracticeVT
Physical Therapist In Private PracticeNY
-VT
-VT
Physical Therapist In Private PracticeVT

Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1063893881 when you need to reference Unknown Individual in forms, claims, or directories.
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 kind of provider is Unknown Individual?
The page reflects Physical Therapist for Unknown Individual. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Oregon?
You will see Eugene, Oregon on file for Unknown Individual alongside any extra practice locations.
What if Eugene, Oregon seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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