Unknown Individual – Neurology Physician, NPI 1124072434

Unknown Individual is a healthcare provider. based in Kirkland, Washington. specializing in Neurology Physician. They hold a License No. MD00020835 (WA). The NPI Number for Unknown Individual is 1124072434

Main info

Organization
Inactive
44 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1124072434
Phone
(425) 899-3270
Address
12040 NE 128TH ST
Deactivation Date
8 January 2025

Doctor Profile

Medical School Name
JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
1982 (44 years ago)
PAC ID
5890790703
Group Practice PAC ID
0244138196
Professional Enrollment ID
I20060928000217
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

  • EvergreenHealth Kirkland, 12040, Northeast 128th Street, Kirkland, King County, Washington, 98034, United States

    MS-10

    KIRKLAND, WA 980343013

    Phone: (425) 899-3270

    Fax: (425) 899-3269

    Type: Mailing

  • 12333, Northeast 130th Lane, Kirkland, King County, Washington, 98034-7114, United States

    SUITE 225

    KIRKLAND, WA 980347467

    Phone: (425) 899-5350

    Fax: (425) 899-5355

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 44 Open Payments records for all available years, with a total value of $32,762.

Total Amount is formed as General ($32,762) + Research ($0) + Ownership ($0) = $32,762.

Last reported payment date: 2024-11-22 • Largest payer in this snapshot: Biogen, Inc. ($10,570).

Total Amount

$32,762

General + Research + Ownership

Payments

44

Total payment records

General Amount

$32,762

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-22

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
99214Established patient office or other outpatient visit, 30-39 minutes207138$0
99213Established patient office or other outpatient visit, 20-29 minutes4937$0
99443Telephone medical discussion with physician, 21-30 minutes1511$0
99215Established patient office or other outpatient visit, 40-54 minutes1211$0
View full utilization report →

Insurance plans in this area (ZIP 98034)

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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: 0244138196View full group profile
NameSpecialtyState
-WA
General SurgeryWA
Orthopedic SurgeryWA
P S Y C H I A T R YWA
Hospitalist, Hospice/Palliative Care, Internal MedicineWA
Hospitalist, Hospice/Palliative CareWA
Physician AssistantWA
N E U R O L O G YWA
N E U R O L O G YWA
Hospitalist, Hospice/Palliative Care, Internal MedicineND

Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1124072434 on file in the registry.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Neurology Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Kirkland, Washington.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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