Unknown Individual – Family Medicine Physician, NPI 1760462964

Unknown Individual is a healthcare provider. based in Taylor, Michigan. specializing in Family Medicine Physician. They hold a License No. 5101011851 (MI). The NPI Number for Unknown Individual is 1760462964

Main info

Organization
Inactive
34 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1760462964
Phone
(734) 403-2222
Address
11368 ALLEN RD
Deactivation Date
27 November 2025

Doctor Profile

Medical School Name
MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
7344032222
Graduation Year
1992 (34 years ago)
PAC ID
5092736363
Group Practice PAC ID
2567483837
Professional Enrollment ID
I20100826001039
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

  • Allen Road, Allard Commons, Southgate, Taylor, Wayne County, Michigan, 48195, United States

    TAYLOR, MI 481804372

    Phone: (734) 403-2222

    Fax: (734) 403-2400

    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 254 Open Payments records for all available years, with a total value of $4,184.

Total Amount is formed as General ($4,184) + Research ($0) + Ownership ($0) = $4,184.

Last reported payment date: 2024-12-19 • Largest payer in this snapshot: ABBVIE INC. ($703).

Total Amount

$4,184

General + Research + Ownership

Payments

254

Total payment records

General Amount

$4,184

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-19

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
82947Blood glucose (sugar) level513230$0
81002Urinalysis, manual test503222$0
99214Established patient office or other outpatient visit, 30-39 minutes482213$0
99213Established patient office or other outpatient visit, 20-29 minutes420191$0
85018Blood count, hemoglobin21560$0
View full utilization report →

Insurance plans in this area (ZIP 48180)

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Provider's Procedures

Unknown Individual performs procedures in Family Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINEMI83036Hemoglobin A1C level180125
FAMILY MEDICINEMI85610Blood test, clotting time4212

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: 2567483837View full group profile

Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1760462964 as the unique 10-digit identifier.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Taylor, Michigan as the reference point for Unknown Individual, then confirm.
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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