Unknown Individual – Acute Care Nurse Practitioner, NPI 1083171912

Unknown Individual is a healthcare provider. based in Johnstown, Pennsylvania. specializing in Acute Care Nurse Practitioner. They hold a License No. SP019618 (PA). The NPI Number for Unknown Individual is 1083171912

Main info

Organization
Inactive
8 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1083171912
Phone
(814) 241-4501
Address
114 RAINBOW DR
Deactivation Date
14 February 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8142473100
Graduation Year
2018 (8 years ago)
PAC ID
0042553414
Group Practice PAC ID
7315166949
Professional Enrollment ID
I20190528002643
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

  • 114 RAINBOW DR

    JOHNSTOWN, PA 159042208

    Phone: (814) 241-4501

    Type: Mailing

  • UPMC Altoona, 620, Howard Avenue, Fairview, Altoona, Blair County, Pennsylvania, 16601, United States

    ALTOONA, PA 166014804

    Phone: (814) 889-2328

    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
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes6329$0
99239Hospital discharge day management, more than 30 minutes4136$0
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes4037$0
View full utilization report →

Insurance plans in this area (ZIP 15904)

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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: 7315166949View full group profile

Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1083171912 as the unique 10-digit identifier.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Acute Care Nurse Practitioner in the directory — Clinical services aligned with this taxonomy classification.
Where in Pennsylvania is Unknown Individual registered?
Use Johnstown, Pennsylvania as the headline location for Unknown Individual here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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