Unknown Individual – Medical Physician Assistant, NPI 1730277070

Unknown Individual is a healthcare provider. based in Cleveland, Ohio. specializing in Medical Physician Assistant. They hold a License No. 50-001350 (OH). The NPI Number for Unknown Individual is 1730277070

Main info

Organization
Inactive
27 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1730277070
Phone
(216) 791-3800
Address
10701 EAST BLVD
Deactivation Date
19 April 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4409533000
Graduation Year
1999 (27 years ago)
PAC ID
8628239340
Group Practice PAC ID
5890738405
Professional Enrollment ID
I20120405000301
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

  • Louis Stokes Cleveland VA Medical Center, 10701, East Boulevard, Magnolia-Wade Park Historic District, University Circle, Cleveland, Cuyahoga County, Ohio, 44106, United States

    CLEVELAND, OH 441061702

    Phone: (216) 791-3800

    Fax: (216) 231-3470

    Type: Location

  • 2925, Coleridge Road, Fairmount Boulevard Historic District, Cleveland Heights, Cuyahoga County, Ohio, 44118, United States

    CLEVELAND HTS, OH 441183507

    Phone: (216) 371-5622

    Type: Mailing

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 44106)

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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: 5890738405View full group profile
NameSpecialtyState
Internal MedicineOH
-OH
Nurse PractitionerOH
Physician AssistantOH
Addiction Medicine, Internal MedicineOH
Nurse PractitionerOH
-OH
Physician AssistantOH
Nurse PractitionerOH
-OH

Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1730277070.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Cleveland?
Unknown Individual currently maps to Cleveland, Ohio in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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