Unknown Individual – Family Medicine Physician, NPI 1013922848

Family Medicine Physician

Unknown Individual is a healthcare provider. based in Cuyahoga falls, Ohio. specializing in Family Medicine Physician. They hold a License No. 34001526D (OH). The NPI Number for Unknown Individual is 1013922848

Main info

Organization

Inactive

62 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1013922848

Phone

(330) 928-6780

Address

3033 STATE RD

Deactivation Date

29 May 2025

Doctor Profile

Medical School Name

AT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE

Secondary Phone

Graduation Year

1964 (62 years ago)

PAC ID

9739159401

Group Practice PAC ID

3072417534

Professional Enrollment ID

I20040729000657

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

3033, State Road, Cuyahoga Falls, Summit County, Ohio, 44223, United States
SUITE 202
CUYAHOGA FALLS, OH 442233614
Phone: (330) 928-6780
Fax: (330) 928-6785
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 44223)

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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: 3072417534View full group profile

Name	Specialty	State
DR. ROBERT B CAMERON (M.D.)	-	OH
PHILIP H KEYSER (MD FACC)	-	OH
STEVEN H SUESS	-	IL
LAURA PESETSKY (CNP)	-	OH
DR. JENNY K SAWYER (M.D.)	-	OH
DR. SAIRA BANU ISMAIL (MD)	-	OH
DR. BRYAN J PACE (D.O.)	Cardiovascular Disease (Cardiology), Internal Medicine	NC
CURTIS W. HAWKINS (M.D.)	-	OH
DR. VINCENT J FRANCZEK (M.D.)	A N E S T H E S I O L O G Y	OH
GREGORY B CORTESE (NP-C)	-	OH