Unknown Individual – Surgery Physician, NPI 1295704161

Surgery Physician

Unknown Individual is a healthcare provider. based in Dublin, Ohio. specializing in Surgery Physician. They hold a License No. 35049331 (OH). The NPI Number for Unknown Individual is 1295704161

Main info

Organization

Inactive

44 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1295704161

Phone

Not provided

Address

5450 FRANTZ RD STE 360

Deactivation Date

19 June 2025

Doctor Profile

Medical School Name

UNIVERSITY OF TOLEDO COLLEGE OF MEDICINE

Secondary Phone

Graduation Year

1982 (44 years ago)

PAC ID

3476586587

Group Practice PAC ID

6305758426

Professional Enrollment ID

I20060215000872

Contacts

Secure Messaging

mbonta21282@direct.ohiohealth.com

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience19

Completeness85

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

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Provider Addresses for Unknown Individual

Frantz Road, Dublin, Franklin, Ohio, 43017, United States
DUBLIN, OH 430164141
Phone:
Type: Mailing
Olentangy River Rd, Knolls-Thomas, Columbus, Sharon, Franklin, Ohio, 43214, United States
RIVERSIDE TRAUMA SERVICES SUITE 13617
COLUMBUS, OH 432143912
Phone: (614) 566-2540
Fax: (614) 566-6692
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 43016)

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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: 6305758426View full group profile

Name	Specialty	State
ANTHONY QUINN JR. TURNER	Nurse Practitioner	OH
JAMIE M MAYO (CNP)	Nurse Practitioner	OH
DR. WILLIAM E ADDINGTON (DO)	Internal Medicine, Family Practice, Urology	OH
MR. DOUGLAS W JOHNSON (PA-C)	Physician Assistant	OH
DR. PRISCA MAYNARD (M.D.)	-	OH
TZVETAN FATCHIKOV (MD)	O B S T E T R I C S/ G Y N E C O L O G Y	MN
DAVID P. LYNCH (D.O.)	General Practice	OH
GRETCHEN M GALLUCCI (NP)	-	OH
ERIKA WILLIAMS	Nurse Practitioner	OH
TAYLOR BELL HYATT	Physician Assistant	OH