Unknown Individual – Medical Physician Assistant, NPI 1689659690

Medical Physician Assistant

Unknown Individual is a healthcare provider. based in Baltimore, Maryland. specializing in Medical Physician Assistant. They hold a License No. C0002631 (MD). The NPI Number for Unknown Individual is 1689659690

Main info

Organization

Inactive

24 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1689659690

Phone

(410) 601-2246

Address

2434 W BELVEDERE AVE

Deactivation Date

18 September 2024

Doctor Profile

Medical School Name

OTHER

Secondary Phone

Graduation Year

2002 (24 years ago)

PAC ID

0446381974

Group Practice PAC ID

7719882943

Professional Enrollment ID

I20100628000821

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

Levindale Hebrew Geriatric Center and Hospital, 2434, West Belvedere Avenue, Levindale, Baltimore, Maryland, 21215, United States
BALTIMORE, MD 212155202
Phone: (410) 601-2246
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)

CMS reports 54 Open Payments records for all available years, with a total value of $1,758.

Total Amount is formed as General ($1,758) + Research ($0) + Ownership ($0) = $1,758.

Last reported payment date: 2024-02-28 • Largest payer in this snapshot: ABBVIE INC. ($454).

Total Amount

$1,758

General + Research + Ownership

Payments

Total payment records

General Amount

$1,758

General payments

Research Amount

Research funding

Ownership Amount

Ownership interests

Ownership Count

Ownership records

Last Payment Date

2024-02-28

Latest reported date

Top Companies

Largest payers in this snapshot

Company	Amount
ABBVIE INC.	$454
INTERCEPT PHARMACEUTICALS, INC.	$299
Gilead Sciences, Inc.	$269
AstraZeneca Pharmaceuticals LP	$140
Salix Pharmaceuticals, a division of Bausch Health US, LLC	$109

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

HCPCS	Description	Services	Beneficiaries	Medicare allowed
99222	Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	14	14	$0
99203	New patient office or other outpatient visit, 30-44 minutes	11	11	$0

View full utilization report →

Insurance plans in this area (ZIP 21215)

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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: 7719882943View full group profile

Name	Specialty	State
DR. ANKUR GUPTA (M.D.)	Diagnostic Radiology	NY
HAOPENG ZHENG (MD)	N E U R O L O G Y	MD
TARA HARDIMAN CHADWICK (M.D., MPH)	O B S T E T R I C S/ G Y N E C O L O G Y	MD
CHRISTINE E. O CONNOR (MD)	-	MD
DR. SADIA REHMAN KHAN (MD)	R H E U M A T O L O G Y	PA
KAMALA H LITTLETON (MD)	-	MD
CHINWE OBINWA (ARNP)	Nurse Practitioner	MD
KIRA NICKOLS (FNP-BC)	Nurse Practitioner	MD
NICOLE M HAMMOND (NP-C)	Nurse Practitioner	MD
BRAD M COGAN (MD)	Diagnostic Radiology	MD