Unknown Individual – Gastroenterology Physician, NPI 1386725968

Unknown Individual is a healthcare provider. based in Minneapolis, Minnesota. specializing in Gastroenterology Physician. They hold a License No. 07-1004 (AZ). The NPI Number for Unknown Individual is 1386725968

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1386725968
Phone
(602) 888-1219
Address
11608 TERRACE RD NE
Deactivation Date
7 June 2021
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 11608 TERRACE RD NE

    ADMINISTRATIVE OFFICE

    MINNEAPOLIS, MN 554341861

    Phone: (602) 888-1219

    Fax: (480) 247-4047

    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.

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Medicare Enrollment & Revalidation

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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 55434)

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Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1386725968.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Gastroenterology Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Minneapolis, Minnesota?
If you are local to Minneapolis, Minnesota, Unknown Individual may be relevant to your search.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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