Unknown Individual – Family Medicine Physician, NPI 1821039116

Unknown Individual is a healthcare provider. based in Sagamore hills, Ohio. specializing in Family Medicine Physician. They hold a License No. 34002387 (OH). The NPI Number for Unknown Individual is 1821039116

Main info

Organization
Inactive
52 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1821039116
Phone
(330) 468-0437
Address
885 W AURORA RD
Deactivation Date
24 August 2021

Doctor Profile

Medical School Name
MIDWESTERN UNIVERSITY, CHICAGO COLLEGE OF OSTEOPATHIC MED
Secondary Phone
-
Graduation Year
1974 (52 years ago)
PAC ID
3870527229
Group Practice PAC ID
3072417534
Professional Enrollment ID
I20091006000581
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

  • 885, West Aurora Road, Sagamore Hills, Sagamore Hills Township, Summit County, Ohio, 44067, United States

    SUITE 1

    SAGAMORE HILLS, OH 440671600

    Phone: (330) 468-0437

    Fax: (330) 468-2100

    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 44067)

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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
FAMILY MEDICINEOH82270Stool analysis for blood to screen for colon tumors3434
FAMILY MEDICINEOH83036Hemoglobin A1C level7030

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: 3072417534View full group profile

Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1821039116 for Unknown Individual.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What does the directory say Unknown Individual does?
Insurance directories may phrase it differently, but here Unknown Individual maps to Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Sagamore Hills, Ohio in registry-derived data.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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