Unknown Individual – Diagnostic Radiology Physician, NPI 1366441180

Unknown Individual is a healthcare provider. based in Federal way, Washington. specializing in Diagnostic Radiology Physician. They hold a License No. MD00036436 (WA). The NPI Number for Unknown Individual is 1366441180

Main info

Organization
Inactive
34 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1366441180
Phone
(253) 661-1700
Address
PO BOX 26730
Deactivation Date
25 September 2025

Doctor Profile

Medical School Name
NORTHWESTERN UNIVERSITY FEINBERG MEDICAL SCHOOL
Secondary Phone
4256565550
Graduation Year
1992 (34 years ago)
PAC ID
2466498720
Group Practice PAC ID
8224937917
Professional Enrollment ID
I20050719000030
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

  • PO BOX 26730

    FEDERAL WAY, WA 980933730

    Phone: (253) 661-1700

    Fax: (253) 661-4565

    Type: Mailing

  • Jex Chiropractic & Massage, 533, South 336th Street, Federal Way, King County, Washington, 98003-5402, United States

    SUITE C

    FEDERAL WAY, WA 980036329

    Phone: (253) 661-1700

    Fax: (253) 661-4565

    Type: Location

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 $24.

Total Amount is formed as General ($24) + Research ($0) + Ownership ($0) = $24.

Last reported payment date: 2024-08-12 • Largest payer in this snapshot: LeMaitre Vascular, Inc. ($24).

Total Amount

$24

General + Research + Ownership

Payments

1

Total payment records

General Amount

$24

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-12

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
LeMaitre Vascular, Inc.$24
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
71045X-ray of chest, 1 view1717$0
76770Complete ultrasound scan behind abdominal cavity1717$0
71046X-ray of chest, 2 views1212$0
71250Ct scan of chest without contrast1212$0
View full utilization report →

Insurance plans in this area (ZIP 98093)

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Provider's Procedures

Unknown Individual performs procedures in Diagnostic Radiology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DIAGNOSTIC RADIOLOGYWA71010X-ray of chest, 1 view, front159149
DIAGNOSTIC RADIOLOGYWA74177CT scan of abdomen and pelvis with contrast115114
DIAGNOSTIC RADIOLOGYWA76830Ultrasound pelvis through vagina2323

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: 8224937917View full group profile
NameSpecialtyState
Interventional RadiologyWI
Physician AssistantWA
Diagnostic RadiologyWA
Diagnostic RadiologyWA
Diagnostic RadiologyWA
Interventional Radiology, Diagnostic RadiologyWA
Diagnostic Radiology, Interventional Radiology, Diagnostic RadiologyCA
Diagnostic RadiologyWA
Diagnostic RadiologyWA
Diagnostic RadiologyWA

Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1366441180 is assigned to Unknown Individual under the national enumeration system.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
Does Unknown Individual list a primary specialty?
If you are matching referrals, note Diagnostic Radiology Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Federal Way, Washington for Unknown Individual; expand the address list for detail.
What if Federal Way, Washington seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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