Unknown Individual – Surgery Physician, NPI 1013943877

Unknown Individual is a healthcare provider. based in Farmington hills, Michigan. specializing in GENERAL SURGERY. They hold a License No. 048654 (MI). The NPI Number for Unknown Individual is 1013943877

Main info

Organization
Inactive
42 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1013943877
Phone
(248) 539-3027
Address
29992 NORTHWESTERN HWY
Deactivation Date
9 April 2026

Doctor Profile

Medical School Name
UNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Secondary Phone
2483550080
Graduation Year
1984 (42 years ago)
PAC ID
3870589039
Group Practice PAC ID
0345413258
Professional Enrollment ID
I20040429000366
Address ID
MI483341573FA32255HWYX302
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

1,444 GENERAL SURGERY in MI

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Provider Addresses for Unknown Individual

  • Northwestern Highway, Farmington Hills, Oakland County, Michigan, 48334, United States

    STE C

    FARMINGTON HILLS, MI 483343292

    Phone: (248) 539-3027

    Fax: (248) 419-3535

    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)

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.

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040429000366IGeneral SurgeryMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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 minutes502340$0
99215Established patient office or other outpatient visit, 40-54 minutes184111$0
99204New patient office or other outpatient visit, 45-59 minutes5656$0
76642Limited ultrasound scan of 1 breast3938$0
View full utilization report →

Insurance plans in this area (ZIP 48334)

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Provider's Procedures

Unknown Individual performs procedures in GENERAL SURGERY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
GENERAL SURGERYMI19301Partial removal of breast3936
GENERAL SURGERYMI38900Lymph node imaging during surgery2020

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: 0345413258View full group profile
NameSpecialtyState
Cardiovascular Disease (Cardiology)MI
-MI
-MI
-MI
Internal MedicineMI
Otolaryngology, Plastic And Reconstructive SurgeryMI
Medical Oncology, Internal MedicineMI
-MI
-AE
Pediatric MedicineMI

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 1013943877.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Surgery Physician. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Farmington Hills, Michigan in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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Surgery Specialists

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NPI: 1205948510