Unknown Individual – Family Medicine Physician, NPI 1487630323

Unknown Individual is a healthcare provider. based in Cincinnati, Ohio. specializing in Family Medicine Physician. They hold a License No. 35-069382 (OH). The NPI Number for Unknown Individual is 1487630323

Main info

Organization
Inactive
32 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1487630323
Phone
(440) 816-4965
Address
PO BOX 638269
Deactivation Date
27 March 2024

Doctor Profile

Medical School Name
WRIGHT STATE UNIVERSITY BOONSHOFT SCHOOL OF MEDICINE
Secondary Phone
4408165390
Graduation Year
1994 (32 years ago)
PAC ID
3274607205
Group Practice PAC ID
8527964550
Professional Enrollment ID
I20080808000234

Contacts

Secure Messaging
okovacevic@direct.swgeneral.com
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

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Provider Addresses for Unknown Individual

  • PO BOX 638269

    CINCINNATI, OH 452630001

    Phone: (440) 816-4965

    Fax: (440) 816-6438

    Type: Mailing

  • 18181, Pearl Road, Fieldstone Preserve, Strongsville, Cuyahoga County, Ohio, 44136, United States

    B202

    STRONGSVILLE, OH 441366949

    Phone: (440) 816-4965

    Fax: (440) 816-4970

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 140 Open Payments records for all available years, with a total value of $2,150.

Total Amount is formed as General ($2,150) + Research ($0) + Ownership ($0) = $2,150.

Last reported payment date: 2024-07-09 • Largest payer in this snapshot: ABBVIE INC. ($445).

Total Amount

$2,150

General + Research + Ownership

Payments

140

Total payment records

General Amount

$2,150

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-07-09

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes277186$0
99213Established patient office or other outpatient visit, 20-29 minutes222149$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit9393$0
83036Hemoglobin a1c level8640$0
90662Influenza vaccine split virus, preservative free5454$0
View full utilization report →

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: 8527964550View full group profile
NameSpecialtyState
Gastroenterology, Internal MedicineOH
Nurse PractitionerOH
O B S T E T R I C S/ G Y N E C O L O G YOH
Nurse PractitionerOH
Certified Registered Nurse Anesthetist (Crna)OH
Anesthesiology AssistantCO
-OH
Anesthesiology AssistantOH
-OH
-OH

Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1487630323 when you need to reference Unknown Individual in forms, claims, or directories.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Cincinnati, Ohio because that is what the record indicates for Unknown Individual.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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