Unknown Individual – Anatomic Pathology & Clinical Pathology Physician, NPI 1619014388

Unknown Individual is a healthcare provider. based in Bend, Oregon. specializing in Anatomic Pathology & Clinical Pathology Physician. They hold a License No. MD25725 (OR). The NPI Number for Unknown Individual is 1619014388

Main info

Organization
Inactive
26 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1619014388
Phone
(541) 382-7696
Address
1348 NE CUSHING DR
Deactivation Date
31 July 2024

Doctor Profile

Medical School Name
UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Secondary Phone
8008132000
Graduation Year
2000 (26 years ago)
PAC ID
5092735365
Group Practice PAC ID
5799688230
Professional Enrollment ID
I20051201000180

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness85
Years active:0State licenses:1Other namesUpdated within 12 months

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Provider Addresses for Unknown Individual

  • Northeast Cushing Drive, Bend, Deschutes County, Oregon, 97701, United States

    STE. 200

    BEND, OR 977013876

    Phone: (541) 382-7696

    Fax: (541) 389-5723

    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
85025Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count5731$0
80053Blood test, comprehensive group of blood chemicals3922$0
81001Manual urinalysis test with examination using microscope, automated1915$0
80048Blood test, basic group of blood chemicals (calcium, total)1311$0
View full utilization report →

Insurance plans in this area (ZIP 97701)

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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: 5799688230View full group profile
NameSpecialtyState
U R O L O G YTX
Emergency MedicineOR
D E R M A T O L O G YAZ
Nurse PractitionerOR
Diagnostic RadiologyOR
D E R M A T O L O G YWA
-OR
-CA
General SurgeryCA
-OR

Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1619014388 if you need a stable reference for Unknown Individual.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Anatomic Pathology & Clinical Pathology Physician. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Bend, Oregon for Unknown Individual based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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