Unknown Individual – Cardiovascular Disease Physician, NPI 1154418176

Unknown Individual is a healthcare provider. based in Mc henry, Maryland. specializing in Cardiovascular Disease Physician. They hold a License No. D0054070 (MD). The NPI Number for Unknown Individual is 1154418176

Main info

Organization
Inactive
48 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1154418176
Phone
(304) 636-5006
Address
2501 Deep Creek Dr Ste 200
Deactivation Date
26 February 2026

Doctor Profile

Medical School Name
WEST VIRGINIA UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
3045998802
Graduation Year
1978 (48 years ago)
PAC ID
4789666322
Group Practice PAC ID
9638073380
Professional Enrollment ID
I20101021000738
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 2501 Deep Creek Dr Ste 200

    Mc Henry, MD 215411713

    Phone: (304) 636-5006

    Fax: (304) 636-4898

    Type: Location

  • 2000 MON HEALTH MEDICAL PARK DRIVE

    SUITE 2300

    MORGANTOWN, WV 26505

    Phone: (304) 599-8802

    Fax: (304) 599-5607

    Type: Location

  • Monongalia Arts Center, 107, High Street, Chancery Hill, Morgantown, Monongalia County, West Virginia, 26505, United States

    MORGANTOWN, WV 265071615

    Phone: (304) 599-8802

    Fax: (304) 599-5607

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 142 Open Payments records for all available years, with a total value of $2,588.

Total Amount is formed as General ($2,588) + Research ($0) + Ownership ($0) = $2,588.

Last reported payment date: 2024-12-05 • Largest payer in this snapshot: ZOLL Services LLC (A/K/A ZOLL LifeCor Corp) ($487).

Total Amount

$2,588

General + Research + Ownership

Payments

142

Total payment records

General Amount

$2,588

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-05

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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
93306Ultrasound of heart with color-depicted blood flow, rate, direction and valve function508502$0
93000Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report259246$0
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only254232$0
99214Established patient office or other outpatient visit, 30-39 minutes252205$0
99212Established patient office or other outpatient visit, 10-19 minutes134127$0
View full utilization report →

Insurance plans in this area (ZIP 21541)

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Provider's Procedures

Unknown Individual performs procedures in Cardiovascular Disease Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
CARDIOVASCULAR DISEASE (CARDIOLOGY)WV93010Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report10691
CARDIOVASCULAR DISEASE (CARDIOLOGY)WV93458Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart4140
CARDIOVASCULAR DISEASE (CARDIOLOGY)WV93971Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers121113

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: 9638073380View full group profile
NameSpecialtyState
Vascular Surgery, Thoracic Surgery, General SurgeryWV
General SurgeryPA
-WV
Family PracticeWV
Internal Medicine, Pediatric MedicineWV
-WV
-WV
O P H T H A L M O L O G YWV
-WV
Nurse PractitionerWV

Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1154418176.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual's primary classification?
Cardiovascular Disease Physician is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Mc Henry, Maryland in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
3 practice locations appear in the available data.

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