Unknown Individual – Orthopaedic Surgery Physician, NPI 1770567752

Unknown Individual is a healthcare provider. based in Flagstaff, Arizona. specializing in Orthopaedic Surgery Physician. They hold a License No. 13320 (AZ). The NPI Number for Unknown Individual is 1770567752

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1770567752
Phone
(928) 773-2538
Address
77 W FOREST AVE
Deactivation Date
1 February 2023
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

  • 77, West Forest Avenue, Hospital Hill, Flagstaff, Coconino County, Arizona, 86001, United States

    SUITE 301

    FLAGSTAFF, AZ 860011479

    Phone: (928) 773-2538

    Fax: (928) 773-2236

    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)

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 86001)

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Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1770567752.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Orthopaedic Surgery Physician in this dataset. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Flagstaff, Arizona; more addresses can appear in NPPES.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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