Unknown Individual – Psychiatry Physician, NPI 1487732954

Unknown Individual is a healthcare provider. based in Cleveland heights, Ohio. specializing in Psychiatry Physician. They hold a License No. D7477 (TX). The NPI Number for Unknown Individual is 1487732954

Main info

Organization
Inactive
61 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1487732954
Phone
Not provided
Address
2460 FAIRMOUNT BLVD
Deactivation Date
11 May 2021

Doctor Profile

Medical School Name
CLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
Secondary Phone
2162834400
Graduation Year
1965 (61 years ago)
PAC ID
9234294372
Group Practice PAC ID
1052218922
Professional Enrollment ID
I20090224000514
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

  • 2460, Fairmount Boulevard, Euclid Golf Historic District, Euclid Heights, Cleveland Heights, Cuyahoga County, Ohio, 44106, United States

    CLEVELAND HEIGHTS, OH 441063171

    Phone:

    Mailing address matches the actual address.

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 44106)

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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: 1052218922View full group profile
NameSpecialtyState
-OH
Mental Health CounselorOH
P S Y C H I A T R YOH
Psychiatry, Addiction MedicineNY
Nurse PractitionerOH
Nurse PractitionerOH
Physician AssistantOH
Clinical Social WorkerOH
-OH

Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1487732954; it appears in the national provider directory.
What is the next step if Unknown Individual is inactive?
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 Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Ohio?
You will see Cleveland Heights, Ohio on file for Unknown Individual alongside any extra practice locations.
What if Cleveland Heights, Ohio seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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