Unknown Individual – Endocrinology, Diabetes & Metabolism Physician, NPI 1003817594

Unknown Individual is a healthcare provider. based in Macomb, Michigan. specializing in Endocrinology, Diabetes & Metabolism Physician. They hold a License No. 4301073359 (MI). The NPI Number for Unknown Individual is 1003817594

Main info

Organization
Inactive
40 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1003817594
Phone
(586) 566-4522
Address
15959 HALL RD
Deactivation Date
28 November 2024

Doctor Profile

Medical School Name
LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
2486963170
Graduation Year
1986 (40 years ago)
PAC ID
0143291104
Group Practice PAC ID
8628965175
Professional Enrollment ID
I20040803001300
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

  • 15959, Hall Road, Clinton Township, Macomb County, Michigan, 48038, United States

    SUITE 210

    MACOMB, MI 480445363

    Phone: (586) 566-4522

    Fax: (586) 566-4771

    Type: Mailing

  • 24 FRANK LLOYD WRIGHT DR LBBY J2000

    ANN ARBOR, MI 481059484

    Phone: (734) 747-6766

    Fax: (734) 222-3100

    Type: Mailing

  • 1854 W AUBURN RD STE 100A

    ROCHESTER HILLS, MI 483093868

    Phone: (248) 696-3170

    Fax: (248) 696-3175

    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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes25592$0
99204New patient office or other outpatient visit, 45-59 minutes2222$0
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Insurance plans in this area (ZIP 48044)

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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: 8628965175View full group profile
NameSpecialtyState
-MI
Family PracticeMI
-IL
-MI
Internal Medicine, Cardiovascular Disease (Cardiology)MI
-MI
Pediatric MedicineMI
Gynecological Oncology, Obstetrics/GynecologyMI
Nurse PractitionerTN
Internal Medicine, Pediatric MedicineMI

Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1003817594 — the number used across U.S. healthcare to identify this provider.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Endocrinology, Diabetes & Metabolism Physician. Clinical services aligned with this taxonomy classification.
Where in Michigan is Unknown Individual registered?
Use Macomb, Michigan as the headline location for Unknown Individual here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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