Unknown Individual – Family Medicine Physician, NPI 1851377360

Unknown Individual is a healthcare provider. based in Detroit, Michigan. specializing in Family Medicine Physician. They hold a License No. 5101007828 (MI). The NPI Number for Unknown Individual is 1851377360

Main info

Organization
Inactive
47 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1851377360
Phone
(313) 836-5490
Address
16226 GRAND RIVER AVE
Deactivation Date
29 August 2024

Doctor Profile

Medical School Name
MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
3138365490
Graduation Year
1979 (47 years ago)
PAC ID
7719020486
Group Practice PAC ID
2365585023
Professional Enrollment ID
I20100812000507
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

  • Grand River Avenue, North Corktown, Midtown, Detroit, Wayne County, Michigan, 48208, United States

    DETROIT, MI 482271824

    Phone: (313) 836-5490

    Fax: (313) 836-5224

    Type: Location

  • 46605, Stratford Court, Northville Hills, Northville Charter Township, Wayne County, Michigan, 48167, United States

    NORTHVILLE, MI 481671721

    Phone: (313) 836-5490

    Fax: (313) 836-5224

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 7 Open Payments records for all available years, with a total value of $113.

Total Amount is formed as General ($113) + Research ($0) + Ownership ($0) = $113.

Last reported payment date: 2024-05-13 • Largest payer in this snapshot: Exact Sciences Corporation ($45).

Total Amount

$113

General + Research + Ownership

Payments

7

Total payment records

General Amount

$113

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-05-13

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
99213Established patient office or other outpatient visit, 20-29 minutes16794$0
36415Insertion of needle into vein for collection of blood sample14197$0
99497Advance care planning, first 30 minutes3232$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit3030$0
99212Established patient office or other outpatient visit, 10-19 minutes2925$0
View full utilization report →

Insurance plans in this area (ZIP 48227)

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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: 2365585023View full group profile
NameSpecialtyState
-MI

Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1851377360 is assigned to Unknown Individual under the national enumeration system.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Detroit, Michigan for Unknown Individual; download NPPES for the complete set.
What if Detroit, Michigan seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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FAMILY PRACTICE

Family Medicine Physician
Grand River Avenue, North Corktown, Midtown, Detroit, Wayne County, Michigan, 48208, United States
NPI: 1659378487