Unknown Individual – Nephrology Physician, NPI 1649229360

Unknown Individual is a healthcare provider. based in Dublin, Ohio. specializing in Nephrology Physician. They hold a License No. 35-04-5856 (OH). The NPI Number for Unknown Individual is 1649229360

Main info

Organization
Inactive
51 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1649229360
Phone
(614) 793-1980
Address
200 BRADENTON AVE
Deactivation Date
4 September 2025

Doctor Profile

Medical School Name
UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
Secondary Phone
6146240101
Graduation Year
1975 (51 years ago)
PAC ID
8325955248
Group Practice PAC ID
7517860208
Professional Enrollment ID
I20100415000653
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

  • 200, Bradenton Avenue, Dublin, Franklin, Ohio, 43017, United States

    DUBLIN, OH 430177515

    Phone: (614) 793-1980

    Fax: (614) 793-1985

    Type: Mailing

  • 285, East State Street, Discovery District, Columbus, Franklin, Ohio, 43215, United States

    SUITE 360

    COLUMBUS, OH 432154354

    Phone: (614) 621-0101

    Fax: (614) 621-1930

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 14 Open Payments records for all available years, with a total value of $282.

Total Amount is formed as General ($282) + Research ($0) + Ownership ($0) = $282.

Last reported payment date: 2024-12-20 • Largest payer in this snapshot: ANI Pharmaceuticals, Inc. ($145).

Total Amount

$282

General + Research + Ownership

Payments

14

Total payment records

General Amount

$282

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-20

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
90960Dialysis services, 4 or more physician visits per month (20 years or older)15330$0
90961Dialysis services, 2-3 physician visits per month (20 years or older)9630$0
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Insurance plans in this area (ZIP 43017)

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Provider's Procedures

Unknown Individual performs procedures in Nephrology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
NEPHROLOGYOH90961Dialysis services (2-3 physician visits per month), patient 20 years of age and older12350

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: 7517860208View full group profile

Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1649229360 as the unique 10-digit identifier.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Nephrology Physician. Clinical services aligned with this taxonomy classification.
Where in Ohio is Unknown Individual registered?
Use Dublin, Ohio as the headline location for Unknown Individual here.
Does Unknown Individual accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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