Unknown Individual – Medical Physician Assistant, NPI 1780801753

Medical Physician Assistant

Unknown Individual is a healthcare provider. based in Pleasant grove, Utah. specializing in Medical Physician Assistant. They hold a License No. 100804-1206 (UT). The NPI Number for Unknown Individual is 1780801753

Main info

Organization

Inactive

Name

Unknown Individual

NPI

1780801753

Phone

(801) 701-0172

Address

436 E. APPLE BLOSSOM LN.

Deactivation Date

30 March 2021

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

Provider Addresses for Unknown Individual

436 E. APPLE BLOSSOM LN.
PLEASANT GROVE, UT 84062
Phone: (801) 701-0172
Type: Mailing
155 NORTH 400 WEST
OREM, UT 84057
Phone: (801) 224-1300
Fax: (801) 225-3536
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.

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 84062)

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Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?

Yes. Unknown Individual is listed with NPI 1780801753 in the public NPI dataset.

Why is Unknown Individual marked inactive in the NPI directory?

The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.

What taxonomy line describes Unknown Individual?

For research purposes, treat Unknown Individual as Medical Physician Assistant in this dataset. Clinical services aligned with this taxonomy classification.

Where should I expect Unknown Individual on a map?

Expect Pleasant Grove, Utah as a primary anchor for Unknown Individual unless the record lists multiple sites.

How many locations tie to this NPI?

2 practice locations appear in the available data.