Unknown Individual – Internal Medicine Physician, NPI 1407817828

Unknown Individual is a healthcare provider. based in Portage, Indiana. specializing in Internal Medicine Physician. They hold a License No. 01030830 (IN). The NPI Number for Unknown Individual is 1407817828

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1407817828
Phone
(219) 759-1157
Address
3630 WILLOWCREEK RD
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

  • Portage Hospital, 3630, Willowcreek Road, Portage, Porter County, Indiana, 46368, United States

    PORTAGE, IN 463685075

    Phone: (219) 759-1157

    Fax: (219) 759-3807

    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)

CMS reports 1 Open Payments records for all available years, with a total value of $14.

Total Amount is formed as General ($14) + Research ($0) + Ownership ($0) = $14.

Last reported payment date: 2023-11-16 • Largest payer in this snapshot: ABBVIE INC. ($14).

Total Amount

$14

General + Research + Ownership

Payments

1

Total payment records

General Amount

$14

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-11-16

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$14
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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 46368)

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Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1407817828 for Unknown Individual, then check state licensing separately.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Portage, Indiana in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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