Unknown Individual – Physician Assistant, NPI 1902193550

Unknown Individual is a healthcare provider. based in Niles, Michigan. specializing in Physician Assistant. They hold a License No. 5601001254 (MI). The NPI Number for Unknown Individual is 1902193550

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1902193550
Phone
(269) 683-6100
Address
703 E MAIN ST
Deactivation Date
6 September 2023
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 703 E MAIN ST

    NILES, MI 491202637

    Phone: (269) 683-6100

    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.

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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 49120)

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Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1902193550?
NPI 1902193550 belongs to Unknown Individual; compare other details if you need extra assurance.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Physician Assistant. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Niles?
Unknown Individual currently maps to Niles, Michigan in this extract.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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