Unknown Individual – Physical Therapist, NPI 1578681458

Physical Therapist

Unknown Individual is a healthcare provider. based in Chardon, Ohio. specializing in Physical Therapist. They hold a License No. PT007004 (OH). The NPI Number for Unknown Individual is 1578681458

Main info

Organization

Inactive

31 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1578681458

Phone

(440) 285-4999

Address

150 SEVENTH AVE

Deactivation Date

20 March 2025

Doctor Profile

Medical School Name

OTHER

Secondary Phone

4402854438

Graduation Year

1995 (31 years ago)

PAC ID

6800986068

Group Practice PAC ID

4880678325

Professional Enrollment ID

I20071212000474

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience14

Completeness75

Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

150 SEVENTH AVE
SUITE 200
CHARDON, OH 44024
Phone: (440) 285-4999
Fax: (440) 285-4996
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.

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

HCPCS	Description	Services	Beneficiaries	Medicare allowed
97110	Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes	447	120	$0
97112	Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes	125	48	$0
97161	Evaluation for physical therapy, typically 20 minutes	64	62	$0
97530	Therapy procedure using functional activities	48	23	$0
97140	Therapy procedure using manual technique, each 15 minutes	47	25	$0

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Insurance plans in this area (ZIP 44024)

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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: 4880678325View full group profile