Unknown Individual – Pediatric Surgery Physician, NPI 1235242207

Unknown Individual is a healthcare provider. based in Dayton, Ohio. specializing in Pediatric Surgery Physician. They hold a License No. 35-06-4788C (OH). The NPI Number for Unknown Individual is 1235242207

Main info

Organization
Inactive
41 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1235242207
Phone
(937) 641-3000
Address
1 CHILDRENS PLZ
Deactivation Date
20 September 2023

Doctor Profile

Medical School Name
WRIGHT STATE UNIVERSITY BOONSHOFT SCHOOL OF MEDICINE
Secondary Phone
9376414000
Graduation Year
1985 (41 years ago)
PAC ID
9537457437
Group Practice PAC ID
5496916124
Professional Enrollment ID
I20191021003314
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience18
Completeness75
Years active:0State licenses:2Digital endpointsOther names

Provider Addresses for Unknown Individual

  • Dayton Children’s Hospital, 1, Childrens Plaza, Dayton, Montgomery County, Ohio, 45404, United States

    DAYTON, OH 454041815

    Phone: (937) 641-3000

    Type: Mailing

  • 3333 W Tech Rd

    Miamisburg, OH 453420955

    Phone: (937) 641-4000

    Fax: (937) 641-4500

    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 45404)

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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: 5496916124View full group profile
NameSpecialtyState
Critical Care (Intensivists)OH
Emergency Medicine, Pediatric MedicineNY
G A S T R O E N T E R O L O G YOH
-OH
Pediatric Medicine, General SurgeryOH
A N E S T H E S I O L O G YTN
Pediatric MedicineOH
Critical Care (Intensivists), Pediatric MedicineOH
H E M A T O L O G Y/ O N C O L O G YOH
Pediatric MedicineOH

Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?
The NPI 1235242207 uniquely identifies Unknown Individual in U.S. healthcare data.
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 does the directory say Unknown Individual does?
Insurance directories may phrase it differently, but here Unknown Individual maps to Pediatric Surgery Physician. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Dayton, Ohio?
For routing, start with Dayton, Ohio for Unknown Individual, then verify phone and hours locally.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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