Unknown Individual – Emergency Medicine Physician, NPI 1356311401

Unknown Individual is a healthcare provider. based in Plano, Texas. specializing in Emergency Medicine Physician. They hold a License No. 01055930 (IN). The NPI Number for Unknown Individual is 1356311401

Main info

Organization
Inactive
27 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1356311401
Phone
(972) 758-3598
Address
PO BOX 869359
Deactivation Date
5 June 2024

Doctor Profile

Medical School Name
UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Secondary Phone
3123550450
Graduation Year
1999 (27 years ago)
PAC ID
8022149608
Group Practice PAC ID
0042108110
Professional Enrollment ID
I20100625000348
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

  • PO BOX 869359

    PLANO, TX 750869359

    Phone: (972) 758-3598

    Type: Mailing

  • Community Hospital, 901, MacArthur Boulevard, Munster, Lake County, Indiana, 46321, United States

    MUNSTER, IN 463212901

    Phone: (219) 836-7049

    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 75086)

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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: 0042108110View full group profile

Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1356311401?
NPI 1356311401 belongs to Unknown Individual; compare other details if you need extra assurance.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Plano?
Public fields place Unknown Individual around Plano, Texas. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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