Unknown Individual – Anatomic Pathology & Clinical Pathology Physician, NPI 1114912011

Unknown Individual is a healthcare provider. based in Columbus, Ohio. specializing in Anatomic Pathology & Clinical Pathology Physician. They hold a License No. 35061202W (OH). The NPI Number for Unknown Individual is 1114912011

Main info

Organization
Inactive
40 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1114912011
Phone
(614) 442-2406
Address
PO BOX 20452
Deactivation Date
17 January 2024

Doctor Profile

Medical School Name
SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
9377712462
Graduation Year
1986 (40 years ago)
PAC ID
1658446752
Group Practice PAC ID
1456374859
Professional Enrollment ID
I20080826000027
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • PO BOX 20452

    VPI CRED

    COLUMBUS, OH 432200452

    Phone: (614) 442-2406

    Fax: (614) 442-2410

    Type: Mailing

  • 160, Wyoming Street, Dayton, Montgomery County, Ohio, 45409, United States

    DAYTON, OH 454092740

    Phone: (937) 224-9326

    Fax: (937) 224-1010

    Type: Location

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
88305Pathology examination of tissue using a microscope, intermediate complexity443261$0
88341Special stained specimen slides to examine tissue, each additional procedure28943$0
88307Pathology examination of tissue using a microscope, moderately high complexity8855$0
88342Special stained specimen slides to examine tissue, initial procedure7458$0
88112Cell examination of specimen, selective cellular enhancement technique6854$0
View full utilization report →

Insurance plans in this area (ZIP 43220)

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Provider's Procedures

Unknown Individual performs procedures in Anatomic Pathology & Clinical Pathology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PATHOLOGYOH88307Pathology examination of tissue using a microscope, moderately high complexity7741
PATHOLOGYOH88342Tissue or cell analysis by immunologic technique6457

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: 1456374859View full group profile
NameSpecialtyState
H E M A T O L O G Y/ O N C O L O G YOH
-OH
Radiation OncologyOH
H E M A T O L O G Y/ O N C O L O G YOH
U R O L O G YOH
H E M A T O L O G Y/ O N C O L O G YOH
Nurse PractitionerOH
-OH
U R O L O G YOH
-OH

Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1114912011 — is the standard way to identify this listing.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Anatomic Pathology & Clinical Pathology Physician. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Columbus, Ohio in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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