Unknown Individual – Psychiatry Physician, NPI 1013990753

Unknown Individual is a healthcare provider. based in Indianapolis, Indiana. specializing in Psychiatry Physician. They hold a License No. 01055395A (IN). The NPI Number for Unknown Individual is 1013990753

Main info

Organization
Inactive
48 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1013990753
Phone
Not provided
Address
250 W 96TH ST # 520
Deactivation Date
28 December 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7654525611
Graduation Year
1978 (48 years ago)
PAC ID
5597754564
Group Practice PAC ID
1153318720
Professional Enrollment ID
I20040506001263
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

  • 520, West 96th Street, Carmel, Hamilton County, Indiana, 46260, United States

    INDIANAPOLIS, IN 462601316

    Phone:

    Type: Mailing

  • 1448 S A St

    Elwood, IN 460361903

    Phone: (765) 552-4611

    Type: Location

  • 1907 W Sycamore St

    Kokomo, IN 469015148

    Phone: (765) 456-5900

    Type: Location

  • South B Street, Elwood, Madison County, Indiana, 46036, United States

    ELWOOD, IN 46036

    Phone: (765) 552-4611

    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 46260)

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: 1153318720View full group profile
NameSpecialtyState
Clinical PsychologistIN
-IN
Mental Health CounselorIN
P S Y C H I A T R YIN
Psychiatry, NeurologyIN
Clinical Social WorkerIN
P S Y C H I A T R YIN
H E M A T O L O G Y/ O N C O L O G YIN
Nurse PractitionerIN
Mental Health CounselorIN

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1013990753.
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 is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Psychiatry Physician. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Indianapolis, Indiana; more addresses can appear in NPPES.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

Similar Providers

DR. MICHAEL J DEAL (M.D.)

Psychiatry Physician
8122, Madison Avenue, Southport, Indianapolis, Indiana, 46227, United States
NPI: 1285632992

DR. MICHAEL L NICHOLAS (M.D.)

Psychiatry Physician
9615, East 148th Street, Noblesville, Hamilton County, Indiana, 46060, United States
NPI: 1124026059

DR. BETSY ROSIEK (M.D.)

Psychiatry Physician
9615, East 148th Street, Noblesville, Hamilton County, Indiana, 46060, United States
NPI: 1053319095

SHAUN P WOOD (MD)

Psychiatry Physician
300 North Meridian, 300, North Meridian Street, Indianapolis, Marion, Indiana, 46204, United States
NPI: 1568461788

DR. MARIA CAROL POOR (MD)

Psychiatry Physician
Richard A. Roudebush VA Medical Center, 1481, West 10th Street, Indianapolis, Marion, Indiana, 46202, United States
NPI: 1609878149

DAVID RAY DIAZ (MD)

Psychiatry Physician
Goodman Campbell Brain and Spine, 355, West 16th Street, Indianapolis, Marion, Indiana, 46224, United States
NPI: 1932101391

DR. BROCK P NOLAN (M.D.)

Psychiatry Physician
610, East Southport Road, Lindenwood, Indianapolis, Indiana, 46227, United States
NPI: 1336131168

SONIA BAYANI YBALLE (MD)

Psychiatry Physician
8401, Harcourt Road, Indianapolis, Marion County, Indiana, 46260, United States
NPI: 1306838784