Unknown Individual – Orthopaedic Surgery Physician, NPI 1538166756

Orthopaedic Surgery Physician

Unknown Individual is a healthcare provider. based in Medford, Oregon. specializing in Orthopaedic Surgery Physician. They hold a License No. MD18693 (OR). The NPI Number for Unknown Individual is 1538166756

Main info

Organization

Inactive

38 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1538166756

Phone

(541) 734-9030

Address

815 N CENTRAL AVE

Deactivation Date

2 October 2024

Doctor Profile

Medical School Name

UNIVERSITY OF CALIFORNIA, SAN DIEGO SCHOOL OF MEDICINE

Secondary Phone

5418582515

Graduation Year

1988 (38 years ago)

PAC ID

9436143831

Group Practice PAC ID

7618876723

Professional Enrollment ID

I20101103000334

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

815, North Central Avenue, Medford, Jackson County, Oregon, 97501, United States
SUITE C
MEDFORD, OR 975015873
Phone: (541) 734-9030
Type: Mailing
Valley Immediate Care North Medford, 1600, Delta Waters Road, Medford, Jackson County, Oregon, 97504, United States
SUITE 107
MEDFORD, OR 975049114
Phone: (541) 858-2515
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.

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

Insurance plans in this area (ZIP 97501)

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Provider's Procedures

Unknown Individual performs procedures in Orthopaedic Surgery Physician. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
ORTHOPEDIC SURGERY	OR	20610	Aspiration and/or injection of large joint or joint capsule	52	36
ORTHOPEDIC SURGERY	OR	73562	X-ray of knee, 3 views	17	12

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: 7618876723View full group profile

Name	Specialty	State
GREGORY RYAN CALDWELL (P.A-C)	Physician Assistant	CA
MRS. LAUREN E HODGDON (FNP)	Nurse Practitioner	PA
KATHRYN A WARNER (FNP)	-	OR
MICHAEL DANIEL BARKER (PAC)	Physician Assistant	OR
ERICA RENEE LINGAFELTER	Nurse Practitioner	OR
KAMARA MARIE DODD (FNP)	Nurse Practitioner	OR
DANIEL KLEPACZ (PA-C)	Physician Assistant	MT
MICHELINE I CAVALLACCI (PA-C)	-	OR
MR. DEREK BRENT KORDENBROCK (NP)	Nurse Practitioner	OR
HANNAH JAYNE HAYES	Physician Assistant	OR

Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?

Unknown Individual — NPI 1538166756 — is the standard way to identify this listing.

Is Unknown Individual excluded from programs when inactive?

The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.

What taxonomy line describes Unknown Individual?

For research purposes, treat Unknown Individual as Orthopaedic Surgery Physician in this dataset. Clinical services aligned with this taxonomy classification.

Does Unknown Individual list a practice location?

Patients near Medford, Oregon may find Unknown Individual in results; validate coverage separately.

Is specialty guaranteed by NPI alone?

Taxonomy selections describe intent; scope of practice still follows state law.