Unknown Individual – Emergency Medicine Physician, NPI 1942260963

Unknown Individual is a healthcare provider. based in Maple grove, Minnesota. specializing in Emergency Medicine Physician. They hold a License No. 024280 (MN). The NPI Number for Unknown Individual is 1942260963

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1942260963
Phone
(763) 420-7048
Address
12000 ELM CREEK BLVD N
Deactivation Date
22 January 2026
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

  • Arbor Lakes Medical Building, 12000, Elm Creek Boulevard, Main Street Arbor Lakes, Maple Grove, Hennepin County, Minnesota, 55369, United States

    #140

    MAPLE GROVE, MN 553697073

    Phone: (763) 420-7048

    Fax: (763) 420-7938

    Type: Location

  • 6613, West Shore Drive, Lake Cornelia, Edina, Hennepin County, Minnesota, 55435, United States

    EDINA, MN 554351528

    Phone: (952) 920-6600

    Fax: (952) 925-5141

    Type: Mailing

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 55369)

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Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1942260963 on file in the registry.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Emergency Medicine Physician in the directory — Clinical services aligned with this taxonomy classification.
Where in Minnesota is Unknown Individual registered?
Use Maple Grove, Minnesota as the headline location for Unknown Individual here.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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