Unknown Individual – Surgery Physician, NPI 1679573166

Unknown Individual is a healthcare provider. based in Lafayette, Indiana. specializing in Surgery Physician. They hold a License No. 01064182A (IN). The NPI Number for Unknown Individual is 1679573166

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1679573166
Phone
(765) 448-8000
Address
PO BOX 5545
Deactivation Date
25 August 2022
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Prophetstown Aquatic Center, 5545, Swisher Road, West Lafayette, Tippecanoe County, Indiana, 47906, United States

    LAFAYETTE, IN 479035545

    Phone: (765) 448-8000

    Fax: (765) 448-8335

    Type: Mailing

  • 2600, Greenbush Street, Eastwich, Lafayette, Tippecanoe County, Indiana, 47904, United States

    LAFAYETTE, IN 479042477

    Phone: (765) 448-8000

    Fax: (765) 448-8027

    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 47903)

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Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1679573166.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Surgery Physician. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Lafayette, Indiana because that is what the record indicates for Unknown Individual.
What if Lafayette, Indiana seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.