Unknown Individual – Cardiovascular Disease Physician, NPI 1295717205

Unknown Individual is a healthcare provider. based in Troy, Michigan. specializing in Cardiovascular Disease Physician. They hold a License No. 4301048905 (MI). The NPI Number for Unknown Individual is 1295717205

Main info

Organization
Inactive
42 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1295717205
Phone
(248) 267-5050
Address
4600 INVESTMENT DR
Deactivation Date
14 April 2022

Doctor Profile

Medical School Name
MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE
Secondary Phone
2482675050
Graduation Year
1984 (42 years ago)
PAC ID
8022077684
Group Practice PAC ID
9335051093
Professional Enrollment ID
I20050526000260
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

  • UnaSource Health, 4600, Investment Drive, Troy, Oakland County, Michigan, 48098, United States

    SUITE 200

    TROY, MI 480986365

    Phone: (248) 267-5050

    Fax: (248) 267-5051

    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 4 Open Payments records for all available years, with a total value of $0.

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

Last reported payment date: • Largest payer in this snapshot: Viseon, Inc. ($0).

Total Amount

$0

General + Research + Ownership

Payments

4

Total payment records

General Amount

$0

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

4

Ownership records

Last Payment Date

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Viseon, Inc.$0
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.

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

Insurance plans in this area (ZIP 48098)

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Provider's Procedures

Unknown Individual performs procedures in Cardiovascular Disease Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
INTERVENTIONAL CARDIOLOGYMI78452Nuclear medicine study of vessels of heart using drugs or exercise multiple studies5555
INTERVENTIONAL CARDIOLOGYMI93458Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart1313

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: 9335051093View full group profile
NameSpecialtyState
Interventional Cardiology, Cardiovascular Disease (Cardiology)MI
-MI
-MI
-MI
-MI
O B S T E T R I C S/ G Y N E C O L O G YMI
-MI
-MI
-MI
O B S T E T R I C S/ G Y N E C O L O G YMI

Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1295717205 — the number used across U.S. healthcare to identify this provider.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Cardiovascular Disease Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Troy, Michigan.
Can I trust this NPI listing for Unknown Individual?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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