Unknown Individual – Foot & Ankle Surgery Podiatrist, NPI 1508860354

Foot & Ankle Surgery Podiatrist

Unknown Individual is a healthcare provider. based in Louisville, Kentucky. specializing in Foot & Ankle Surgery Podiatrist. They hold a License No. 00144 (KY). The NPI Number for Unknown Individual is 1508860354

Main info

Organization

Inactive

48 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1508860354

Phone

Not provided

Address

734 W MAIN ST STE 100

Deactivation Date

7 October 2022

Doctor Profile

Medical School Name

NEW YORK COLLEGE OF PODIATRIC MEDICINE

Secondary Phone

5029682233

Graduation Year

1978 (48 years ago)

PAC ID

0648169953

Group Practice PAC ID

4880752443

Professional Enrollment ID

I20040315000234

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

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Provider Addresses for Unknown Individual

100, West Main Street, Louisville, Jefferson County, Kentucky, 40202, United States
LOUISVILLE, KY 402023687
Phone:
Type: Mailing
4612, Outer Loop, Louisville, Jefferson County, Kentucky, 40219, United States
LOUISVILLE, KY 402193971
Phone: (502) 968-2233
Fax: (502) 968-2283
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 40202)

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Provider's Procedures

Unknown Individual performs procedures in Foot & Ankle Surgery Podiatrist. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
PODIATRY	KY	11042	Removal of skin and tissue first 20 sq cm or less	43	16
PODIATRY	KY	73630	X-ray of foot, minimum of 3 views	88	70

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: 4880752443View full group profile

Name	Specialty	State
JASMINE NEAL (DPM)	-	KY
MAKENZIE LYNN KERNS	P O D I A T R Y	TX
ANGELA BINNS DIDYK (DPM)	P O D I A T R Y	KY
DR. JILL LYNES (DPT)	-	KY
AMANDA L DENZIK (DPM)	P O D I A T R Y	KY
ABRAHAM ZIA ADAM (DPM)	P O D I A T R Y	MI
DR. SARA R MILLAR (DPM)	P O D I A T R Y	KY
MARINA ISAC (DPM)	P O D I A T R Y	IL
MR. RONALD COLE (PT)	-	KY
DR. SYED AHMED (DPM)	P O D I A T R Y	KY

Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?

Use NPI 1508860354 when you need to reference Unknown Individual in forms, claims, or directories.

How do I interpret inactive records for Unknown Individual?

Treat inactive as a signal to verify Unknown Individual through official channels.

What does Unknown Individual treat or focus on?

Patients typically see Unknown Individual under the specialty Foot & Ankle Surgery Podiatrist. Clinical services aligned with this taxonomy classification.

Where is Unknown Individual's primary listing?

We display Louisville, Kentucky because that is what the record indicates for Unknown Individual.

Is Unknown Individual a real provider?

This page reflects official NPPES data for NPI 1508860354. Always confirm identity and privileges with the practice and licensing boards.