Unknown Individual – Family Medicine Physician, NPI 1265452494

Unknown Individual is a healthcare provider. based in Sterling heights, Michigan. specializing in Family Medicine Physician. They hold a License No. 5101006679 (MI). The NPI Number for Unknown Individual is 1265452494

Main info

Organization
Inactive
53 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1265452494
Phone
(586) 323-0400
Address
42755 MOUND RD
Deactivation Date
6 December 2023

Doctor Profile

Medical School Name
MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
5863230400
Graduation Year
1973 (53 years ago)
PAC ID
1850370776
Group Practice PAC ID
7416088463
Professional Enrollment ID
I20040715000232
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

  • Mound Road, Sterling Heights, Macomb County, Michigan, 48092, United States

    STERLING HEIGHTS, MI 483143255

    Phone: (586) 323-0400

    Fax: (586) 323-3762

    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 14 Open Payments records for all available years, with a total value of $260.

Total Amount is formed as General ($260) + Research ($0) + Ownership ($0) = $260.

Last reported payment date: 2023-10-24 • Largest payer in this snapshot: Novartis Pharmaceuticals Corporation ($104).

Total Amount

$260

General + Research + Ownership

Payments

14

Total payment records

General Amount

$260

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-10-24

Latest reported date

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
99214Established patient office or other outpatient visit, 30-39 minutes355166$0
85025Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count162120$0
99213Established patient office or other outpatient visit, 20-29 minutes14491$0
81002Urinalysis, manual test11697$0
G0444Annual depression screening, 5 to 15 minutes4747$0
View full utilization report →

Insurance plans in this area (ZIP 48314)

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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: 7416088463View full group profile
NameSpecialtyState
Gastroenterology, Internal MedicineMI
Internal MedicineMI
Physical Medicine And RehabilitationMI
Cardiovascular Disease (Cardiology), Internal Medicine, Interventional CardiologyMI
Internal Medicine, GastroenterologyMI
Nephrology, Internal MedicineMI
Gastroenterology, Internal MedicineMI
P O D I A T R YMI
Nephrology, Internal MedicineMI

Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1265452494 for Unknown Individual.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
How should patients interpret Unknown Individual's specialty?
The extract shows Family Medicine Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Sterling Heights, Michigan in registry-derived data.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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