Unknown Individual – Family Medicine Physician, NPI 1720076532

Unknown Individual is a healthcare provider. based in Huber heights, Ohio. specializing in Family Medicine Physician. They hold a License No. 35027441F (OH). The NPI Number for Unknown Individual is 1720076532

Main info

Organization
Inactive
62 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1720076532
Phone
(937) 233-0132
Address
6096 BRANDT PIKE
Deactivation Date
15 March 2023

Doctor Profile

Medical School Name
OHIO STATE UNIVERSITY COLLEGE OF MEDICINE
Secondary Phone
9372330132
Graduation Year
1964 (62 years ago)
PAC ID
9739178427
Group Practice PAC ID
9739178419
Professional Enrollment ID
I20100830000007
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

  • 6096, Brandt Pike, Huber Heights, Montgomery County, Ohio, 45424, United States

    HUBER HEIGHTS, OH 454244015

    Phone: (937) 233-0132

    Fax: (937) 233-9127

    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 45424)

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Provider's Procedures

Unknown Individual performs procedures in Family Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
GENERAL PRACTICEOH81002Urinalysis, manual test2625

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: 9739178419View full group profile

Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?
The NPI 1720076532 uniquely identifies Unknown Individual in U.S. healthcare data.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
How should patients interpret Unknown Individual's specialty?
The extract shows Family Medicine Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Huber Heights, Ohio in the same public data insurers reference.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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