Unknown Individual – Orthopaedic Surgery Physician, NPI 1790797504

Unknown Individual is a healthcare provider. based in Elko, Nevada. specializing in Orthopaedic Surgery Physician. They hold a License No. MD60095213 (WA). The NPI Number for Unknown Individual is 1790797504

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1790797504
Phone
(775) 738-1770
Address
770 S. 12TH ST
Deactivation Date
13 March 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:0State licenses:5Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 770, South 12th Street, Gateway River Estates, Elko, Elko County, Nevada, 89801, United States

    ELKO, NV 898014054

    Phone: (775) 738-1770

    Fax: (775) 738-5341

    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 89801)

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Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1790797504 if you need a stable reference for Unknown Individual.
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 kind of provider is Unknown Individual?
The page reflects Orthopaedic Surgery Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Elko, Nevada because that is what the record indicates for Unknown Individual.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.