Unknown Individual – Physician Assistant, NPI 1063861367

Unknown Individual is a healthcare provider. based in Wenatchee, Washington. specializing in Physician Assistant. They hold a License No. PA60668985 (WA). The NPI Number for Unknown Individual is 1063861367

Main info

Organization
Inactive
10 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1063861367
Phone
(509) 663-8711
Address
820 N CHELAN AVE
Deactivation Date
19 July 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5093678733
Graduation Year
2016 (10 years ago)
PAC ID
6103110945
Group Practice PAC ID
5092093542
Professional Enrollment ID
I20160802002187
Data current as of
20 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

  • Wenatchee Valley Medical Center, 820, North Chelan Avenue, Wenatchee, Chelan County, Washington, 98801, United States

    WENATCHEE, WA 988012028

    Phone: (509) 663-8711

    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)

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes3636$0
99214Established patient office or other outpatient visit, 30-39 minutes3331$0
99204New patient office or other outpatient visit, 45-59 minutes3232$0
99203New patient office or other outpatient visit, 30-44 minutes2525$0
81003Automated urinalysis test2221$0
View full utilization report →

Insurance plans in this area (ZIP 98801)

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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: 5092093542View full group profile
NameSpecialtyState
Physician AssistantFL
Nurse PractitionerWA
Physician AssistantWA
-WA
Nurse PractitionerWA
Family PracticeWA
Physician AssistantWA
Nurse PractitionerWA
-WA
Physician AssistantWA

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 1063861367 for Unknown Individual.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Physician Assistant. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Wenatchee, Washington?
For routing, start with Wenatchee, Washington for Unknown Individual, then verify phone and hours locally.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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