Unknown Individual – Diagnostic Radiology Physician, NPI 1073597720

Unknown Individual is a healthcare provider. based in Boulder, Colorado. specializing in Diagnostic Radiology Physician. They hold a License No. 22100 (CO). The NPI Number for Unknown Individual is 1073597720

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1073597720
Phone
(303) 440-3000
Address
2750 BROADWAY ST
Deactivation Date
15 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

  • Broadway, The Hill, Boulder, Boulder County, Colorado, 80802, United States

    BOULDER, CO 803043573

    Phone: (303) 440-3000

    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 80304)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1073597720 — is the standard way to identify this listing.
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 Diagnostic Radiology Physician in this dataset. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Boulder, Colorado may find Unknown Individual in results; validate coverage separately.
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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