Unknown Individual – Diagnostic Radiology Physician, NPI 1053353250

Unknown Individual is a healthcare provider. based in Lexington, Kentucky. specializing in Diagnostic Radiology Physician. They hold a License No. 32518 (KY). The NPI Number for Unknown Individual is 1053353250

Main info

Organization
Inactive
46 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1053353250
Phone
(859) 219-0542
Address
1218 S BROADWAY
Deactivation Date
7 August 2025

Doctor Profile

Medical School Name
UNIVERSITY OF VIRGINIA SCHOOL OF MEDICINE
Secondary Phone
5023505000
Graduation Year
1980 (46 years ago)
PAC ID
1951341437
Group Practice PAC ID
8921906983
Professional Enrollment ID
I20050504000212
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 1218, South Broadway, South Broadway Park, Lexington, Fayette County, Kentucky, 40504, United States

    SUITE 310

    LEXINGTON, KY 405042759

    Phone: (859) 219-0542

    Fax: (859) 219-9433

    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.

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
71045X-ray of chest, 1 view762668$0
70450Ct scan head or brain without contrast358345$0
74176Ct scan of abdomen and pelvis without contrast268265$0
74177Ct scan of abdomen and pelvis with contrast222219$0
71250Ct scan of chest without contrast207202$0
View full utilization report →

Insurance plans in this area (ZIP 40504)

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Provider's Procedures

Unknown Individual performs procedures in Diagnostic Radiology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DIAGNOSTIC RADIOLOGYKY71010X-ray of chest, 1 view, front13941198
DIAGNOSTIC RADIOLOGYKY71250CT scan chest384371
DIAGNOSTIC RADIOLOGYKY73110X-ray of wrist, minimum of 3 views3636
DIAGNOSTIC RADIOLOGYKY73562X-ray of knee, 3 views1111
DIAGNOSTIC RADIOLOGYKY73630X-ray of foot, minimum of 3 views6258
DIAGNOSTIC RADIOLOGYKY74177CT scan of abdomen and pelvis with contrast554530
DIAGNOSTIC RADIOLOGYKY93971Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers1313

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: 8921906983View full group profile
NameSpecialtyState
Diagnostic RadiologyKY
Diagnostic RadiologyKY
Diagnostic RadiologyKY
Diagnostic RadiologyKY
-CA
Diagnostic RadiologyCO
Diagnostic RadiologyMN
Diagnostic RadiologyCA
Diagnostic RadiologyIA
-CA

Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1053353250.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Diagnostic Radiology Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Lexington, Kentucky in the same public data insurers reference.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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