Unknown Individual – Internal Medicine Physician, NPI 1144228917

Unknown Individual is a healthcare provider. based in Clarkston, Michigan. specializing in Internal Medicine Physician. They hold a License No. 4301052322 (MI). The NPI Number for Unknown Individual is 1144228917

Main info

Organization
Inactive
39 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1144228917
Phone
(248) 625-2621
Address
5701 BOW POINTE DR STE 100
Deactivation Date
12 February 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2486252621
Graduation Year
1987 (39 years ago)
PAC ID
3971654062
Group Practice PAC ID
0345413258
Professional Enrollment ID
I20090701000249
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

  • 5701 BOW POINTE DR STE 100

    CLARKSTON, MI 483463199

    Phone: (248) 625-2621

    Fax: (248) 625-2622

    Type: Mailing

  • Daimler Truck, North America

    13400 Outer Drive

    Detroit, MI 48239

    Phone: (313) 592-5216

    Fax: (313) 543-0527

    Type: Location

  • 37771 Schoenherr Rd Ste 102

    Sterling Heights, MI 483122302

    Phone: (586) 978-1300

    Type: Location

  • 1749 E MAPLE RD

    BIRMINGHAM, MI 480096505

    Phone: (248) 703-4148

    Type: Mailing

  • 41800 W 11 MILE RD STE 109

    NOVI, MI 483751818

    Phone: (248) 660-1220

    Fax: (248) 256-3799

    Type: Location

  • 33717 WOODWARD AVE APT 250

    BIRMINGHAM, MI 480090913

    Phone: (248) 703-4148

    Type: Mailing

  • 37771 SCHOENHERR RD STE 102

    STERLING HEIGHTS, MI 483122302

    Phone: (586) 978-1300

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 16 Open Payments records for all available years, with a total value of $324.

Total Amount is formed as General ($324) + Research ($0) + Ownership ($0) = $324.

Last reported payment date: 2024-05-16 • Largest payer in this snapshot: USWM, LLC ($87).

Total Amount

$324

General + Research + Ownership

Payments

16

Total payment records

General Amount

$324

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-05-16

Latest reported date

Top Companies

Largest payers in this snapshot

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
99306Initial nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes2220$0
View full utilization report →

Insurance plans in this area (ZIP 48346)

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Provider's Procedures

Unknown Individual performs procedures in Internal Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
INTERNAL MEDICINEMI82270Stool analysis for blood to screen for colon tumors1818
INTERNAL MEDICINEMI90670Pneumococcal vaccine for injection into muscle2323

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

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1144228917 as the unique 10-digit identifier.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Where in Michigan is Unknown Individual registered?
Use Clarkston, Michigan as the headline location for Unknown Individual here.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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