Unknown Individual – Orthopaedic Surgery Physician, NPI 1811982044

Unknown Individual is a healthcare provider. based in Wyoming, Michigan. specializing in Orthopaedic Surgery Physician. They hold a License No. KH013102 (MI). The NPI Number for Unknown Individual is 1811982044

Main info

Organization
Inactive
30 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1811982044
Phone
(616) 252-3243
Address
5900 BYRON CENTER AVE SW
Deactivation Date
5 November 2025

Doctor Profile

Medical School Name
MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
6162528300
Graduation Year
1996 (30 years ago)
PAC ID
3779543137
Group Practice PAC ID
5597651836
Professional Enrollment ID
I20041013001038
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

  • 5900, Byron Center Avenue Southwest, Wyoming, Kent County, Michigan, 49519, United States

    MEDICAL ADMINISTRATION

    WYOMING, MI 495199606

    Phone: (616) 252-3243

    Fax: (616) 252-0260

    Type: Mailing

  • 2215, 44th Street Southwest, Wyoming, Kent County, Michigan, 49519, United States

    WYOMING, MI 495196439

    Phone: (616) 252-5777

    Fax: (616) 252-5757

    Type: Location

  • 12809 WILDERNESS TRL

    GRAND HAVEN, MI 494177638

    Phone: (616) 914-1344

    Type: Mailing

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 49519)

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Provider's Procedures

Unknown Individual performs procedures in Orthopaedic Surgery Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
ORTHOPEDIC SURGERYMI20610Aspiration and/or injection of large joint or joint capsule10161

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: 5597651836View full group profile
NameSpecialtyState
MATTHEW AARON ERCK (DO)
Internal MedicineMI
MARK J TIESZEN (MD)
-MI
CASSANDRA PAIGE FRITCH (NP)
Nurse PractitionerMI
REBECCA S ZERIAL (PA-C)
Physician AssistantMI
DR. NATALIE KENT (D.O.)
Hospitalist, Internal MedicineMI
KRISTINE NICOLE TOMLINSON-MILES (NP)
-MI
DR. MATTHEW WESLEY MEDLEY (DO)
Family PracticeMI
MR. TYLER JOHN SCHAEFER (PA-C)
Physician AssistantMI
SUSAN K HICKS (D.O.)
-MI
ASHLEY A WILDA (PA-C)
Physician AssistantMI

Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1811982044 in the public NPI dataset.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Orthopaedic Surgery Physician. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Wyoming, Michigan as a primary anchor for Unknown Individual unless the record lists multiple sites.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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