Unknown Individual – Anesthesiology Physician, NPI 1053306449

Unknown Individual is a healthcare provider. based in Youngstown, Ohio. specializing in Anesthesiology Physician. They hold a License No. 35084385 (OH). The NPI Number for Unknown Individual is 1053306449

Main info

Organization
Inactive
27 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1053306449
Phone
(330) 759-9350
Address
3622 BELMONT AVE
Deactivation Date
13 September 2023

Doctor Profile

Medical School Name
UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Secondary Phone
9372086173
Graduation Year
1999 (27 years ago)
PAC ID
0648244731
Group Practice PAC ID
8820902794
Professional Enrollment ID
I20040824000904
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

  • Relaced 330, 3622, Belmont Avenue, Youngstown, Trumbull County, Ohio, 44505, United States

    SUITE 1

    YOUNGSTOWN, OH 445051450

    Phone: (330) 759-9350

    Fax: (330) 759-9387

    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 44505)

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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: 8820902794View full group profile
NameSpecialtyState
A N E S T H E S I O L O G YOH
Certified Registered Nurse Anesthetist (Crna)OH
-OH
-GA
Certified Registered Nurse Anesthetist (Crna)OH
Certified Registered Nurse Anesthetist (Crna)OH
-OH
A N E S T H E S I O L O G YOH
A N E S T H E S I O L O G YOH
-OH

Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1053306449 when you need to reference Unknown Individual in forms, claims, or directories.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
Does Unknown Individual list a primary specialty?
If you are matching referrals, note Anesthesiology Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Youngstown, Ohio for Unknown Individual; download NPPES for the complete set.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1053306449. Always confirm identity and privileges with the practice and licensing boards.

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