Unknown Individual – Physician Assistant, NPI 1427007509

Physician Assistant

Unknown Individual is a healthcare provider. based in Panama city, Florida. specializing in Physician Assistant. They hold a License No. 50-002306 (OH). The NPI Number for Unknown Individual is 1427007509

Main info

Organization

Inactive

24 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1427007509

Phone

(850) 785-4344

Address

1827 Harrison Ave

Deactivation Date

6 November 2025

Doctor Profile

Medical School Name

OTHER

Secondary Phone

Graduation Year

2002 (24 years ago)

PAC ID

4789695057

Group Practice PAC ID

6305758426

Professional Enrollment ID

I20060530000032

Contacts

Secure Messaging

bploskodniak410439@direct.ohiohealth.com

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience14

Completeness85

Years active:0State licenses:1Other namesUpdated within 12 months

Provider Addresses for Unknown Individual

1827 Harrison Ave
Panama City, FL 324057605
Phone: (850) 785-4344
Type: Location
Youngstown Orthopaedic Associates, 6470, Tippecanoe Road, Creekside Professional Centre, Starr's Corners, Canfield, Canfield Township, Mahoning County, Ohio, 44406, United States
CANFIELD, OH 444067036
Phone: (330) 758-0577
Fax: (330) 533-1772
Type: Mailing
Boardman Canfield Road, Boardman Plaza, Boardman, Mahoning County, Ohio, 44512, United States
BOARDMAN, OH 445124008
Phone: (330) 758-0577
Fax: (330) 533-4587
Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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 32405)

Loading plans...

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 6305758426View full group profile

Name	Specialty	State
ANTHONY QUINN JR. TURNER	Nurse Practitioner	OH
JAMIE M MAYO (CNP)	Nurse Practitioner	OH
DR. WILLIAM E ADDINGTON (DO)	Internal Medicine, Family Practice, Urology	OH
MR. DOUGLAS W JOHNSON (PA-C)	Physician Assistant	OH
DR. PRISCA MAYNARD (M.D.)	-	OH
TZVETAN FATCHIKOV (MD)	O B S T E T R I C S/ G Y N E C O L O G Y	MN
DAVID P. LYNCH (D.O.)	General Practice	OH
GRETCHEN M GALLUCCI (NP)	-	OH
ERIKA WILLIAMS	Nurse Practitioner	OH
TAYLOR BELL HYATT	Physician Assistant	OH