Unknown Individual – Psychiatry Physician, NPI 1619964202

Unknown Individual is a healthcare provider. based in Columbus, Ohio. specializing in Psychiatry Physician. They hold a License No. 35.042947 (OH). The NPI Number for Unknown Individual is 1619964202

Main info

Organization
Inactive
59 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1619964202
Phone
(614) 752-0333
Address
2200 W BROAD ST
Deactivation Date
11 December 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6147520333
Graduation Year
1967 (59 years ago)
PAC ID
6709808082
Group Practice PAC ID
0143133181
Professional Enrollment ID
I20051230000057
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

  • 2200, West Broad Street, Hilltop, Columbus, Franklin County, Ohio, 43223, United States

    COLUMBUS, OH 432231297

    Phone: (614) 752-0333

    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 43223)

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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: 0143133181View full group profile

Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1619964202 is assigned to Unknown Individual under the national enumeration system.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Columbus, Ohio because that is what the record indicates for Unknown Individual.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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