Unknown Individual – Pediatric Endocrinology Physician, NPI 1053494542

Pediatric Endocrinology Physician

Unknown Individual is a healthcare provider. based in Minneapolis, Minnesota. specializing in Pediatric Endocrinology Physician. They hold a License No. 20682 (MN). The NPI Number for Unknown Individual is 1053494542

Main info

Organization

Inactive

Name

Unknown Individual

NPI

1053494542

Phone

(612) 626-6777

Address

420 DELAWARE STREET SE

Deactivation Date

18 February 2022

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

Mayo Memorial Building, 420, Southeast Delaware Street, Minneapolis, Hennepin County, Minnesota, 55455, United States
UNIVERSITY OF MINNESOTA PHYSICIANS
MINNEAPOLIS, MN 55455
Phone: (612) 626-6777
Type: Mailing
Phillips-Wangensteen Building, 516, Southeast Delaware Street, Minneapolis, Hennepin County, Minnesota, 55455, United States
PWB 4TH FLOOR, ROOM 4-100
MINNEAPOLIS, MN 554550356
Phone: (612) 626-6777
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.

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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 55455)

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Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?

You can confirm Unknown Individual with NPI 1053494542; it appears in the national provider directory.

Why would Unknown Individual's listing show inactive?

Inactive in NPPES means the identifier is not currently active in that dataset.

What field does Unknown Individual work in?

You can think of Unknown Individual as practicing within Pediatric Endocrinology Physician. Clinical services aligned with this taxonomy classification.

Where is Unknown Individual's primary listing?

We display Minneapolis, Minnesota because that is what the record indicates for Unknown Individual.

What if Minneapolis, Minnesota seems incomplete?

Street-level detail can be omitted — open the full address list for this NPI.