Unknown Individual – Surgical Physician Assistant, NPI 1346225851

Unknown Individual is a healthcare provider. based in Bend, Oregon. specializing in Surgical Physician Assistant. They hold a License No. PA00325 (OR). The NPI Number for Unknown Individual is 1346225851

Main info

Organization
Inactive
39 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1346225851
Phone
(541) 388-3006
Address
1715 SW CHANDLER AVE
Deactivation Date
30 December 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1987 (39 years ago)
PAC ID
2668572694
Professional Enrollment ID
I20070705000273
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

  • Southwest Chandler Avenue, Bend, Deschutes County, Oregon, 97702, United States

    STE 100

    BEND, OR 97702

    Phone: (541) 388-3006

    Fax: (541) 382-7605

    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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97702)

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Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1346225851 on file in the registry.
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 Surgical Physician Assistant. Clinical services aligned with this taxonomy classification.
Where in Oregon is Unknown Individual registered?
Use Bend, Oregon as the headline location for Unknown Individual here.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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