Unknown Individual – Anesthesiology Physician, NPI 1457359986

Unknown Individual is a healthcare provider. based in Cincinnati, Ohio. specializing in Anesthesiology Physician. They hold a License No. 23564 (KY). The NPI Number for Unknown Individual is 1457359986

Main info

Organization
Inactive
43 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1457359986
Phone
(513) 865-5204
Address
PO BOX 632572
Deactivation Date
26 July 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5025623000
Graduation Year
1983 (43 years ago)
PAC ID
5092778308
Group Practice PAC ID
3476725599
Professional Enrollment ID
I20190625002646
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Boom Box Buns, 1324, Main Street, Main Street Business District, Over-the-Rhine, Cincinnati, Hamilton County, Ohio, 45202, United States

    CINCINNATI, OH 452632572

    Phone: (513) 865-5204

    Type: Mailing

  • University of Louisville Hospital, 530, South Jackson Street, Louisville, Jefferson County, Kentucky, 40202, United States

    LOUISVILLE, KY 402021675

    Phone: (502) 852-5851

    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 45263)

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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: 3476725599View full group profile
NameSpecialtyState
Nurse PractitionerKY
Nurse PractitionerKY
Nurse PractitionerKY
Diagnostic RadiologyKY
-KY
-KY
Certified Registered Nurse Anesthetist (Crna)TN
O P H T H A L M O L O G YKY
Family PracticeKY
Certified Registered Nurse Anesthetist (Crna)KY

Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1457359986.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
Does Unknown Individual list a primary specialty?
If you are matching referrals, note Anesthesiology Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Ohio?
You will see Cincinnati, Ohio on file for Unknown Individual alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.