Unknown Individual – Pediatric Gastroenterology Physician, NPI 1609805290

Unknown Individual is a healthcare provider. based in Cincinnati, Ohio. specializing in Pediatric Gastroenterology Physician. They hold a License No. 35.043708 (OH). The NPI Number for Unknown Individual is 1609805290

Main info

Organization
Inactive
53 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1609805290
Phone
(513) 636-4225
Address
3333 BURNET AVE
Deactivation Date
14 October 2021

Doctor Profile

Medical School Name
INDIANA UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
5136364200
Graduation Year
1973 (53 years ago)
PAC ID
3274708268
Group Practice PAC ID
8426955733
Professional Enrollment ID
I20111201000754
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

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Provider Addresses for Unknown Individual

  • Cincinnati Children’s Hospital Medical Center, 3333, Burnet Avenue, Pill Hill, Corryville, Cincinnati, Hamilton County, Ohio, 45229-3026, United States

    ML 5021

    CINCINNATI, OH 452293039

    Phone: (513) 636-4225

    Fax: (513) 636-2511

    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 45229)

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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: 8426955733View full group profile

Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1609805290.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Pediatric Gastroenterology Physician in this dataset. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Cincinnati, Ohio may find Unknown Individual in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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