Unknown Individual – Obstetrics & Gynecology Physician, NPI 1164592143

Unknown Individual is a healthcare provider. based in Anacortes, Washington. specializing in Obstetrics & Gynecology Physician. They hold a License No. MD00012334 (WA). The NPI Number for Unknown Individual is 1164592143

Main info

Organization
Inactive
57 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1164592143
Phone
(360) 293-3101
Address
1213 24TH ST
Deactivation Date
19 July 2023

Doctor Profile

Medical School Name
JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
3602991350
Graduation Year
1969 (57 years ago)
PAC ID
1951468776
Group Practice PAC ID
1153225198
Professional Enrollment ID
I20090324000060
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

  • 1213, 24th Street, Anacortes, Skagit County, Washington, 98221, United States

    #100

    ANACORTES, WA 982212592

    Phone: (360) 293-3101

    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 1 Open Payments records for all available years, with a total value of $23.

Total Amount is formed as General ($23) + Research ($0) + Ownership ($0) = $23.

Last reported payment date: 2023-01-02 • Largest payer in this snapshot: PFIZER INC. ($23).

Total Amount

$23

General + Research + Ownership

Payments

1

Total payment records

General Amount

$23

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-01-02

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
PFIZER INC.$23
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 98221)

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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: 1153225198View full group profile
NameSpecialtyState
Physician AssistantWA
O B S T E T R I C S/ G Y N E C O L O G YWA
Critical Care (Intensivists), Pulmonary Disease, Pulmonary Disease, Critical Care (Intensivists)FL
-WA
-NV
Family PracticeOR
-WA
-WA
Family PracticeMT
-NC

Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?
The NPI 1164592143 uniquely identifies Unknown Individual in U.S. healthcare data.
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.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Obstetrics & Gynecology Physician. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Anacortes, Washington?
For routing, start with Anacortes, Washington for Unknown Individual, then verify phone and hours locally.
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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