Unknown Individual – Urology Physician, NPI 1215908074

Unknown Individual is a healthcare provider. based in Gahanna, Ohio. specializing in Urology Physician. They hold a License No. 35056991 (OH). The NPI Number for Unknown Individual is 1215908074

Main info

Organization
Inactive
40 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1215908074
Phone
(614) 944-4800
Address
701 TECH CENTER DR STE 250
Deactivation Date
12 February 2026

Doctor Profile

Medical School Name
WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
6142682323
Graduation Year
1986 (40 years ago)
PAC ID
3375514045
Group Practice PAC ID
5395758882
Professional Enrollment ID
I20060803000274
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

  • Tech Center Drive, Gahanna, Mifflin Township, Ohio, 43213, United States

    GAHANNA, OH 432301987

    Phone: (614) 944-4800

    Fax: (614) 944-4750

    Type: Mailing

  • 701, Tech Center Drive, Gahanna, Mifflin Township, Ohio, 43230, United States

    GAHANNA, OH 432301987

    Phone: (614) 396-2684

    Fax: (614) 396-2480

    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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 43230)

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Provider's Procedures

Unknown Individual performs procedures in Urology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
UROLOGYOH76872Ultrasound of rectum2626

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: 5395758882View full group profile
NameSpecialtyState
Radiation OncologyOH
U R O L O G YOH
U R O L O G YOH
Nurse PractitionerOH
Physician AssistantOH
Nurse PractitionerOH
Nurse PractitionerOH
U R O L O G YOH
U R O L O G YOH
U R O L O G YOH

Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1215908074.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Urology Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Gahanna, Ohio for Unknown Individual; expand the address list for detail.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1215908074. Always confirm identity and privileges with the practice and licensing boards.

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