Unknown Individual – Emergency Medicine Physician, NPI 1316011828

Unknown Individual is a healthcare provider. based in Detroit, Michigan. specializing in Emergency Medicine Physician. They hold a License No. 72939 (MI). The NPI Number for Unknown Individual is 1316011828

Main info

Organization
Inactive
28 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1316011828
Phone
(313) 916-2600
Address
2799 W GRAND BLVD
Deactivation Date
18 February 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2406862300
Graduation Year
1998 (28 years ago)
PAC ID
5799814786
Group Practice PAC ID
4385863059
Professional Enrollment ID
I20100601000629
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

  • Henry Ford Hospital, 2799, West Grand Boulevard, New Center, Detroit, Wayne County, Michigan, 48202, United States

    DETROIT, MI 482022608

    Phone: (313) 916-2600

    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.

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 48202)

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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: 4385863059View full group profile

Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1316011828 on file in the registry.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Emergency Medicine Physician in the directory — Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Detroit?
Unknown Individual currently maps to Detroit, Michigan in this extract.
Does Unknown Individual accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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