Unknown Individual – Dermatology Physician, NPI 1801893698

Unknown Individual is a healthcare provider. based in Toledo, Ohio. specializing in Dermatology Physician. They hold a License No. 35029359I (OH). The NPI Number for Unknown Individual is 1801893698

Main info

Organization
Inactive
60 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1801893698
Phone
(419) 479-5880
Address
4235 SECOR RD
Deactivation Date
4 January 2021

Doctor Profile

Medical School Name
UNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE
Secondary Phone
4194795398
Graduation Year
1966 (60 years ago)
PAC ID
7517980428
Group Practice PAC ID
5698673382
Professional Enrollment ID
I20060106000096
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

  • 4235, Secor Road, Deaveaux, Toledo, Lucas County, Ohio, 43623, United States

    TOLEDO, OH 436234231

    Phone: (419) 479-5880

    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 43623)

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Provider's Procedures

Unknown Individual performs procedures in Dermatology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DERMATOLOGYOH17003Destruction of 2-14 skin growths78274

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: 5698673382View full group profile
NameSpecialtyState
U R O L O G YOH
U R O L O G YOH
Pulmonary Disease, Critical Care (Intensivists)OH
H E M A T O L O G Y/ O N C O L O G YOH
G A S T R O E N T E R O L O G YOH
O B S T E T R I C S/ G Y N E C O L O G YOH
Nurse PractitionerOH
Physician AssistantOH
Nurse PractitionerOH
Orthopedic SurgeryOH

Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1801893698 for Unknown Individual, then check state licensing separately.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Dermatology Physician. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Toledo, Ohio in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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