Unknown Individual – Clinical Cardiac Electrophysiology Physician, NPI 1366451635

Unknown Individual is a healthcare provider. based in Seattle, Washington. specializing in Clinical Cardiac Electrophysiology Physician. They hold a License No. 2017014311 (MO). The NPI Number for Unknown Individual is 1366451635

Main info

Organization
Inactive
22 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1366451635
Phone
(206) 598-3300
Address
1959 NE PACIFIC STREET
Deactivation Date
4 December 2020

Doctor Profile

Medical School Name
HARVARD MEDICAL SCHOOL
Secondary Phone
5734586310
Graduation Year
2004 (22 years ago)
PAC ID
0840295267
Group Practice PAC ID
7416865845
Professional Enrollment ID
I20170626001363
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

  • University of Washington Medical Center - Montlake, 1959, Northeast Pacific Street, University District, Seattle, King County, Washington, 98195, United States

    UNIVERSITY OF WASHINGTON MEDICAL CENTER

    SEATTLE, WA 98195

    Phone: (206) 598-3300

    Type: Mailing

  • South New Ballas Road, Creve Coeur, Saint Louis County, Missouri, 63141, United States

    SAINT LOUIS, MO 631418253

    Phone: (314) 251-1700

    Fax: (314) 251-1701

    Type: Location

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.

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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 98195)

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Provider's Procedures

Unknown Individual performs procedures in Clinical Cardiac Electrophysiology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
CARDIAC ELECTROPHYSIOLOGYMO93280Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report9456

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: 7416865845View full group profile

Reviews

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Frequently asked questions

What is the standard ID for Unknown Individual in the U.S.?
In the U.S., Unknown Individual is identified by NPI 1366451635.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
How should patients interpret Unknown Individual's specialty?
The extract shows Clinical Cardiac Electrophysiology Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Seattle, Washington in the same public data insurers reference.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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