Unknown Individual – Nephrology Physician, NPI 1669448684

Unknown Individual is a healthcare provider. based in Canfield, Ohio. specializing in Nephrology Physician. They hold a License No. 35031967 (OH). The NPI Number for Unknown Individual is 1669448684

Main info

Organization
Inactive
65 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1669448684
Phone
(330) 259-0440
Address
3685 STUTZ DR
Deactivation Date
26 March 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3302590440
Graduation Year
1961 (65 years ago)
PAC ID
4789662255
Group Practice PAC ID
3678551330
Professional Enrollment ID
I20040712000066
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

  • 3685, Stutz Drive, Starr's Corners, Canfield Township, Mahoning County, Ohio, 44406, United States

    SUITE 101

    CANFIELD, OH 444069155

    Phone: (330) 259-0440

    Fax: (330) 259-0441

    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)

CMS reports 33 Open Payments records for all available years, with a total value of $620.

Total Amount is formed as General ($620) + Research ($0) + Ownership ($0) = $620.

Last reported payment date: 2024-06-26 • Largest payer in this snapshot: Bayer Healthcare Pharmaceuticals Inc. ($148).

Total Amount

$620

General + Research + Ownership

Payments

33

Total payment records

General Amount

$620

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-06-26

Latest reported date

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
99214Established patient office or other outpatient visit, 30-39 minutes7630$0
90966Home dialysis services per month (20 years or older)4312$0
View full utilization report →

Insurance plans in this area (ZIP 44406)

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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
NEPHROLOGYOH90966Home dialysis services per month, patient 20 years of age or older12825

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: 3678551330View full group profile
NameSpecialtyState
Nurse PractitionerOH
N E P H R O L O G YOH
Nurse PractitionerOH
N E P H R O L O G YMO
Certified Clinical Nurse Specialist (Cns)OH

Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1669448684 — is the standard way to identify this listing.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Nephrology Physician. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Canfield, Ohio may find Unknown Individual in results; validate coverage separately.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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