Unknown Individual – Family Medicine Physician, NPI 1992781405

Unknown Individual is a healthcare provider. based in Detroit, Michigan. specializing in Family Medicine Physician. They hold a License No. 5101007746 (MI). The NPI Number for Unknown Individual is 1992781405

Main info

Organization
Inactive
47 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1992781405
Phone
(313) 836-5490
Address
16226 GRAND RIVER AVE
Deactivation Date
30 August 2024

Doctor Profile

Medical School Name
MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE
Secondary Phone
3138365490
Graduation Year
1979 (47 years ago)
PAC ID
3173666849
Group Practice PAC ID
2365585023
Professional Enrollment ID
I20100604000719
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

  • 36542, Jefferson Court, Independence Green Apartments, Farmington Hills, Oakland County, Michigan, 48335, United States

    APT 10306

    FARMINGTON HILLS, MI 483351939

    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 5 Open Payments records for all available years, with a total value of $83.

Total Amount is formed as General ($83) + Research ($0) + Ownership ($0) = $83.

Last reported payment date: 2024-05-06 • Largest payer in this snapshot: Exact Sciences Corporation ($45).

Total Amount

$83

General + Research + Ownership

Payments

5

Total payment records

General Amount

$83

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-05-06

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
36415Insertion of needle into vein for collection of blood sample4229$0
99213Established patient office or other outpatient visit, 20-29 minutes2819$0
99214Established patient office or other outpatient visit, 30-39 minutes2622$0
81000Manual urinalysis test with examination using microscope, non-automated2319$0
99212Established patient office or other outpatient visit, 10-19 minutes2115$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 number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1992781405 for Unknown Individual.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
How should patients interpret Unknown Individual's specialty?
The extract shows Family Medicine Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Detroit, Michigan?
For routing, start with Detroit, Michigan for Unknown Individual, then verify phone and hours locally.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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FAMILY PRACTICE

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