Unknown Individual – Psychiatric/Mental Health Nurse Practitioner, NPI 1609002575

Unknown Individual is a healthcare provider. based in Austin, Texas. specializing in Psychiatric/Mental Health Nurse Practitioner. They hold a License No. 645035 (TX). The NPI Number for Unknown Individual is 1609002575

Main info

Organization
Inactive
14 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1609002575
Phone
(512) 430-1130
Address
5424 W HIGHWAY 290 STE 108
Deactivation Date
4 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5127954344
Graduation Year
2012 (14 years ago)
PAC ID
6305092636
Group Practice PAC ID
3779754163
Professional Enrollment ID
I20120802000053
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:0State licenses:3Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Apostille Texas, 108, Wild Basin Road South, Austin, Travis County, Texas, 78746, United States

    AUSTIN, TX 787358827

    Phone: (512) 430-1130

    Fax: (512) 677-6806

    Type: Location

  • West US Highway 290, Austin, Travis County, Texas, 78749, United States

    SUITE 108

    AUSTIN, TX 787357873

    Phone: (512) 430-1130

    Fax: (512) 677-6806

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 20 Open Payments records for all available years, with a total value of $1,391.

Total Amount is formed as General ($1,391) + Research ($0) + Ownership ($0) = $1,391.

Last reported payment date: 2024-11-01 • Largest payer in this snapshot: Alkermes, Inc. ($264).

Total Amount

$1,391

General + Research + Ownership

Payments

20

Total payment records

General Amount

$1,391

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-01

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
G2012Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m servic11622$0
90836Psychotherapy with evaluation and management visit, 45 minutes7624$0
99214Established patient office or other outpatient visit, 30-39 minutes5920$0
View full utilization report →

Insurance plans in this area (ZIP 78735)

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Provider's Procedures

Unknown Individual performs procedures in Psychiatric/Mental Health Nurse Practitioner. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
CERTIFIED CLINICAL NURSE SPECIALISTTX90836Psychotherapy, 45 minutes with patient and/or family member9840

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: 3779754163View full group profile
NameSpecialtyState
Nurse PractitionerTX
-TX
Nurse PractitionerKS
-TX
Certified Clinical Nurse Specialist (Cns)TX
Certified Clinical Nurse Specialist (Cns)TX
Nurse PractitionerTX
-TX
Nurse PractitionerTX
Nurse PractitionerTX

Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1609002575 for Unknown Individual.
What does inactive NPI status mean for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
How should patients interpret Unknown Individual's specialty?
The extract shows Psychiatric/Mental Health Nurse Practitioner for Unknown Individual. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Austin, Texas. Check all listed addresses for suites or satellite offices.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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