Unknown Individual – Geriatric Medicine (Internal Medicine) Physician, NPI 1124148846

Unknown Individual is a healthcare provider. based in Independence, Ohio. specializing in Geriatric Medicine (Internal Medicine) Physician. They hold a License No. 35089927 (OH). The NPI Number for Unknown Individual is 1124148846

Main info

Organization
Inactive
21 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1124148846
Phone
(216) 636-8742
Address
6801 BRECKSVILLE ROAD, STE 10/RK30
Deactivation Date
21 February 2024

Doctor Profile

Medical School Name
CLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
Secondary Phone
2164442200
Graduation Year
2005 (21 years ago)
PAC ID
0345393039
Group Practice PAC ID
1850203555
Professional Enrollment ID
I20090728000518
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

  • 6801 BRECKSVILLE ROAD, STE 10/RK30

    CLEVELAND CLINIC MEDICAL CARE AT HOME

    INDEPENDENCE, OH 441315057

    Phone: (216) 636-8742

    Fax: (216) 636-7877

    Type: Mailing

  • 6801 BRECKSVILLE RD

    SUITE 10/RK30

    INDEPENDENCE, OH 441315032

    Phone: (216) 636-8742

    Fax: (216) 636-7877

    Type: Location

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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99349Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes11553$0
99350Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes10260$0
G0179Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a6626$0
G0318Prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualif4428$0
G0180Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and3931$0
View full utilization report →

Insurance plans in this area (ZIP 44131)

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: 1850203555View full group profile
NameSpecialtyState
-NV
Nephrology, Internal MedicineOH
-OH
-MI
Nurse PractitionerOH
General Surgery, Anesthesiology, Critical Care (Intensivists)OH
Certified Registered Nurse Anesthetist (Crna)OH
-OH
-MN
Nurse PractitionerOH

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

What is the standard ID for Unknown Individual in the U.S.?
In the U.S., Unknown Individual is identified by NPI 1124148846.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Geriatric Medicine (Internal Medicine) Physician. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Independence, Ohio?
For routing, start with Independence, Ohio for Unknown Individual, then verify phone and hours locally.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

Similar Providers

RONAN M FACTORA (MD)

Geriatric Medicine (Internal Medicine) Physician
6000, West Creek Road, Independence, Cuyahoga County, Ohio, 44131, United States
NPI: 1548224223

DR. DUANE E KIRKSEY (MD)

Geriatric Medicine (Internal Medicine) Physician
Cleveland Clinic Business Operations Center, 6801, Brecksville Road, Independence, Cuyahoga County, Ohio, 44141:44286, United States
NPI: 1952492555

MONIKA DEMKO (M.D.)

Geriatric Medicine (Internal Medicine) Physician
7215 OLD OAK BLVD STE A416
NPI: 1225368053
The Vanderbilt Clinic, Medical Center Drive, Nashville, Davidson County, Tennessee, 37212, United States
NPI: 1508182155

Cleveland Clinic Home Care Servic

Hospice and Palliative Medicine (Internal Medicine) Physician
PO BOX 931664
NPI: 1194089292

WellBe Senior Medical Ohio, Inc

Geriatric Medicine (Internal Medicine) Physician
North Michigan Avenue, Michigan Ave, Chicago, Cook County, Illinois, 60611, United States
NPI: 1497308456