Unknown Individual – Physician Assistant, NPI 1861590697

Unknown Individual is a healthcare provider. based in Marshfield, Wisconsin. specializing in Physician Assistant. They hold a License No. 497 (WI). The NPI Number for Unknown Individual is 1861590697

Main info

Organization
Inactive
39 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1861590697
Phone
(715) 393-1000
Address
1000 N OAK AVE
Deactivation Date
12 April 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7153875511
Graduation Year
1987 (39 years ago)
PAC ID
3577690684
Group Practice PAC ID
5698071173
Professional Enrollment ID
I20100421000845
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

  • Marshfield Clinic Marshfield Center, 1000, North Oak Avenue, Marshfield, Wood County, Wisconsin, 54449, United States

    MARSHFIELD, WI 544495777

    Phone: (715) 393-1000

    Type: Mailing

  • Marshfield Clinic Weston Center, 3501, Cranberry Boulevard, Weston Medical Center, Village of Weston, Marathon County, Wisconsin, 54476, United States

    WESTON, WI 54476

    Phone: (715) 387-5129

    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.

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 54449)

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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: 5698071173View full group profile
NameSpecialtyState
-WI
N E U R O L O G YNY
Nurse PractitionerWI
Interventional Radiology, Diagnostic RadiologyWI
-WI
P S Y C H I A T R YIL
-MI
Internal MedicineWI
Nurse PractitionerIL
Cardiovascular Disease (Cardiology)IL

Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1861590697.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Physician Assistant. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Marshfield, Wisconsin?
If you are local to Marshfield, Wisconsin, Unknown Individual may be relevant to your search.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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