Unknown Individual – Gastroenterology Physician, NPI 1265413652

Unknown Individual is a healthcare provider. based in Dayton, Ohio. specializing in Gastroenterology Physician. They hold a License No. 35061651 (OH). The NPI Number for Unknown Individual is 1265413652

Main info

Organization
Inactive
52 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1265413652
Phone
(937) 275-1500
Address
6300 N Main St
Deactivation Date
12 March 2026

Doctor Profile

Medical School Name
STATE UNIVERSITY OF NEW YORK DOWNSTATE MEDICAL CENTER
Secondary Phone
9375347330
Graduation Year
1974 (52 years ago)
PAC ID
3274421029
Group Practice PAC ID
2062300809
Professional Enrollment ID
I20040504001218

Contacts

Secure Messaging
digestivespecialists@directaddress.net
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness85
Years active:0State licenses:1Other namesUpdated within 12 months

Provider Addresses for Unknown Individual

  • 6300 N Main St

    Dayton, OH 454153154

    Phone: (937) 275-1500

    Type: Location

  • 4340 CLYO RD STE 200

    DAYTON, OH 454597000

    Phone: (937) 534-7330

    Fax: (937) 395-3682

    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 45415)

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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: 2062300809View full group profile
NameSpecialtyState
Physician AssistantIL
G A S T R O E N T E R O L O G YOH
-OH
P A T H O L O G YOH
-OH
G A S T R O E N T E R O L O G YOH
G A S T R O E N T E R O L O G YOH
Physician AssistantOH
P A T H O L O G YOH
Physician AssistantOH

Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?
The NPI 1265413652 uniquely identifies Unknown Individual in U.S. healthcare data.
What does inactive NPI status mean for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
What does the directory say Unknown Individual does?
Insurance directories may phrase it differently, but here Unknown Individual maps to Gastroenterology 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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