Unknown Individual – Foot & Ankle Surgery Podiatrist, NPI 1093710147

Foot & Ankle Surgery Podiatrist

Unknown Individual is a healthcare provider. based in Dayton, Ohio. specializing in Foot & Ankle Surgery Podiatrist. They hold a License No. 36002631 (OH). The NPI Number for Unknown Individual is 1093710147

Main info

Organization

Inactive

44 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1093710147

Phone

(937) 312-1661

Address

2350 MIAMI VALLEY DR

Deactivation Date

12 February 2026

Doctor Profile

Medical School Name

KENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE

Secondary Phone

9373121661

Graduation Year

1982 (44 years ago)

PAC ID

7416847264

Group Practice PAC ID

5597708594

Professional Enrollment ID

I20040317000159

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

Provider Addresses for Unknown Individual

2350 MIAMI VALLEY DR
SUITE 320 A
DAYTON, OH 454594778
Phone: (937) 312-1661
Fax: (937) 312-1701
Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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 45459)

Loading plans...

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: 5597708594View full group profile

Name	Specialty	State
MATTHEW JOHN CAVO (M.D.)	Hand Surgery, Orthopedic Surgery	OH
JESSICA LYNN GALLI ROBERTSON (PA-C)	Physician Assistant	OH
JON E SULENTIC (DO)	-	OH
DR. BRYAN JENKINS KING (M.D.)	Cardiovascular Disease (Cardiology)	OH
SUDHAKAR MARABOYINA (MD)	-	OH
JENNIFER RODRIGUEZ FOSTER (PA-C)	Physician Assistant	OH
JOSEPH H HOUDA (MD)	Thoracic Surgery	PA
DOUGLAS E MCCAFFERTY (PA)	Physician Assistant	OH
TRISTIN LEIGH STEPHENS	Nurse Practitioner	OH
JONATHAN M BEISER (PA-C)	Physician Assistant	OH

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

Does Unknown Individual share an NPI with anyone else?

NPI numbers are unique to each provider or organization — Unknown Individual uses 1093710147.

Why is Unknown Individual marked inactive in the NPI directory?

The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.

What taxonomy line describes Unknown Individual?

For research purposes, treat Unknown Individual as Foot & Ankle Surgery Podiatrist in this dataset. Clinical services aligned with this taxonomy classification.

Does Unknown Individual list a practice location?

Patients near Dayton, Ohio may find Unknown Individual in results; validate coverage separately.

Is the information about Unknown Individual up to date?

Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."