Unknown Individual – Anesthesiology Physician, NPI 1013933779

Unknown Individual is a healthcare provider. based in Wheaton, Maryland. specializing in Anesthesiology Physician. They hold a License No. MD30252 (DC). The NPI Number for Unknown Individual is 1013933779

Main info

Organization
Inactive
33 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1013933779
Phone
(301) 946-5100
Address
11510 GEORGIA AVE
Deactivation Date
21 June 2021

Doctor Profile

Medical School Name
UNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE
Secondary Phone
3018917600
Graduation Year
1993 (33 years ago)
PAC ID
2668631003
Group Practice PAC ID
8426039744
Professional Enrollment ID
I20120305000494
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

  • Taxpayer Assistance Center, 11510, Georgia Avenue, Monterrey Village, Kensington View, Wheaton, Montgomery County, Maryland, 20902, United States

    SUITE 206

    WHEATON, MD 209021925

    Phone: (301) 946-5100

    Fax: (301) 929-0348

    Type: Mailing

  • Washington Hospital Center, 110, Irving Street Northwest, Washington, Washington, D.C., 20010, United States

    WASHINGTON, DC 200102976

    Phone: (301) 946-5100

    Fax: (301) 929-0348

    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 20902)

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Provider's Procedures

Unknown Individual performs procedures in Anesthesiology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
ANESTHESIOLOGYDC36620Insertion of arterial catheter for blood sampling or infusion, accessed through the skin2323

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: 8426039744View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)MD
-PA
A N E S T H E S I O L O G YVA
-MD
Certified Registered Nurse Anesthetist (Crna)VA
Certified Registered Nurse Anesthetist (Crna)WV
Certified Registered Nurse Anesthetist (Crna)MD
-MD
-MD
-MD

Reviews

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Frequently asked questions

What is the standard ID for Unknown Individual in the U.S.?
In the U.S., Unknown Individual is identified by NPI 1013933779.
Should I call the clinic if Unknown Individual is inactive here?
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 Anesthesiology Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Wheaton, Maryland in registry-derived data.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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