Unknown Individual – Urology Physician, NPI 1891752218

Unknown Individual is a healthcare provider. based in Germantown, Tennessee. specializing in Urology Physician. They hold a License No. 16135 (MS). The NPI Number for Unknown Individual is 1891752218

Main info

Organization
Inactive
55 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1891752218
Phone
(901) 252-3411
Address
1325 WOLF PARK DR
Deactivation Date
15 November 2024

Doctor Profile

Medical School Name
UNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Secondary Phone
9012523400
Graduation Year
1971 (55 years ago)
PAC ID
2567494529
Group Practice PAC ID
7315832649
Professional Enrollment ID
I20100827000800
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 1325, Wolf Park Drive, Germantown, Shelby County, Tennessee, 38138, United States

    SUITE 103

    GERMANTOWN, TN 381381742

    Phone: (901) 252-3411

    Fax: (901) 384-6422

    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)

CMS reports 13 Open Payments records for all available years, with a total value of $1,221.

Total Amount is formed as General ($1,221) + Research ($0) + Ownership ($0) = $1,221.

Last reported payment date: 2024-07-11 • Largest payer in this snapshot: Myriad Genetic Laboratories, Inc. ($249).

Total Amount

$1,221

General + Research + Ownership

Payments

13

Total payment records

General Amount

$1,221

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-07-11

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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
55866Surgical removal of prostate and surrounding lymph nodes using an endoscope2121$0
38571Removal of lymph nodes of both sides of pelvis using an endoscope2020$0
50543Partial removal of kidney using an endoscope1514$0
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Insurance plans in this area (ZIP 38138)

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Provider's Procedures

Unknown Individual performs procedures in Urology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
UROLOGYTN55700Biopsy of prostate gland2424
UROLOGYTN76942Ultrasonic guidance imaging supervision and interpretation for insertion of needle2424

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: 7315832649View full group profile
NameSpecialtyState
-TN
Diagnostic RadiologyTN
U R O L O G YTN
Diagnostic Radiology, Interventional Radiology, Diagnostic RadiologyFL
Physician AssistantTN
U R O L O G YTN
Physician AssistantTN
U R O L O G YTN
Physician AssistantTN
U R O L O G YMS

Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1891752218 in the public NPI dataset.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's primary classification?
Urology Physician is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Germantown, Tennessee in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.