Unknown Individual – Internal Medicine Physician, NPI 1376640904

Unknown Individual is a healthcare provider. based in Mesquite, Texas. specializing in Internal Medicine Physician. They hold a License No. K6675 (TX). The NPI Number for Unknown Individual is 1376640904

Main info

Organization
Inactive
40 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1376640904
Phone
(972) 329-3500
Address
PO BOX 850752
Deactivation Date
27 March 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9723293500
Graduation Year
1986 (40 years ago)
PAC ID
3274688486
Group Practice PAC ID
8123296498
Professional Enrollment ID
I20110713000297
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

  • Ice Box Canyon, Mesquite, Clark County, Nevada, 89034, United States

    MESQUITE, TX 751850752

    Phone: (972) 329-3500

    Fax: (972) 329-3513

    Type: Mailing

  • North Belt Line Road, Mesquite, Dallas County, Texas, 75043, United States

    MESQUITE, TX 751491722

    Phone: (927) 329-3500

    Fax: (972) 329-3513

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $22.

Total Amount is formed as General ($22) + Research ($0) + Ownership ($0) = $22.

Last reported payment date: 2023-05-26 • Largest payer in this snapshot: Exact Sciences Corporation ($22).

Total Amount

$22

General + Research + Ownership

Payments

1

Total payment records

General Amount

$22

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-05-26

Latest reported date

Top Companies

Largest payers in this snapshot

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
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes2,386401$0
95004Test for allergy using allergenic extract86412$0
99308Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes656162$0
99490Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month53289$0
99457Management using the results of remote vital sign monitoring per calendar month, first 20 minutes34753$0
View full utilization report →

Insurance plans in this area (ZIP 75185)

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Provider's Procedures

Unknown Individual performs procedures in Internal Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
INTERNAL MEDICINETX94060Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration4127

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: 8123296498View full group profile
NameSpecialtyState
Nurse PractitionerTX
-TX

Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1376640904 is assigned to Unknown Individual under the national enumeration system.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Texas?
You will see Mesquite, Texas on file for Unknown Individual alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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