Unknown Individual – Neurology Physician, NPI 1225133929

Unknown Individual is a healthcare provider. based in Port huron, Michigan. specializing in Neurology Physician. They hold a License No. MS44076 (MI). The NPI Number for Unknown Individual is 1225133929

Main info

Organization
Inactive
54 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1225133929
Phone
(810) 985-4100
Address
2603 ELECTRIC AVE
Deactivation Date
2 April 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1972 (54 years ago)
PAC ID
3173785110
Professional Enrollment ID
I20120508000642
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

  • Electric Avenue, Grand Trunk Business Park, Port Huron, Saint Clair County, Michigan, 48060, United States

    STE 2 MOSTAFA S SADRY MD PC

    PORT HURON, MI 48060

    Phone: (810) 985-4100

    Fax: (810) 985-8244

    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 1 Open Payments records for all available years, with a total value of $15.

Total Amount is formed as General ($15) + Research ($0) + Ownership ($0) = $15.

Last reported payment date: 2024-05-17 • Largest payer in this snapshot: TG Therapeutics, Inc. ($15).

Total Amount

$15

General + Research + Ownership

Payments

1

Total payment records

General Amount

$15

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-05-17

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
TG Therapeutics, Inc.$15
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.

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
I20120508000642INeurologyMITBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48060)

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Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1225133929; it appears in the national provider directory.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Neurology Physician. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Port Huron, Michigan for Unknown Individual based on available NPPES addresses.
What if Port Huron, Michigan seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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