Unknown Individual – Surgical Physician Assistant, NPI 1508955931

Unknown Individual is a healthcare provider. based in Wichita falls, Texas. specializing in Surgical Physician Assistant. They hold a License No. PA05078 (TX). The NPI Number for Unknown Individual is 1508955931

Main info

Organization
Inactive
20 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1508955931
Phone
(940) 764-5401
Address
1518 9TH ST
Deactivation Date
20 March 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8004229567
Graduation Year
2006 (20 years ago)
PAC ID
2062518665
Group Practice PAC ID
0840298303
Professional Enrollment ID
I20070427000266
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 1518, 9th Street, Wichita Falls, Wichita County, Texas, 76301, United States

    WICHITA FALLS, TX 763014323

    Phone: (940) 764-5401

    Fax: (940) 764-7245

    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 4 Open Payments records for all available years, with a total value of $215.

Total Amount is formed as General ($215) + Research ($0) + Ownership ($0) = $215.

Last reported payment date: 2023-12-07 • Largest payer in this snapshot: Getinge USA Sales, LLC ($215).

Total Amount

$215

General + Research + Ownership

Payments

4

Total payment records

General Amount

$215

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-12-07

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Getinge USA Sales, LLC$215
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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 76301)

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Provider's Procedures

Unknown Individual performs procedures in Surgical Physician Assistant. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICIAN ASSISTANTTX33405Replacement of left lower heart chamber valve using artificial valve on heart-lung machine3737
PHYSICIAN ASSISTANTTX33533Heart artery bypass to repair one artery3434

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: 0840298303View full group profile

Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1508955931.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Surgical Physician Assistant in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Wichita Falls, Texas?
If you are local to Wichita Falls, Texas, Unknown Individual may be relevant to your search.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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