Unknown Individual – Orthopaedic Surgery Physician, NPI 1821097650

Unknown Individual is a healthcare provider. based in Wooster, Ohio. specializing in Orthopaedic Surgery Physician. They hold a License No. 34006849 (OH). The NPI Number for Unknown Individual is 1821097650

Main info

Organization
Inactive
31 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1821097650
Phone
(330) 804-9712
Address
3373 COMMERCE PKWY
Deactivation Date
5 June 2024

Doctor Profile

Medical School Name
OHIO UNIVERSITY, COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
-
Graduation Year
1995 (31 years ago)
PAC ID
4981752391
Group Practice PAC ID
6204733355
Professional Enrollment ID
I20091217000073
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

Provider Addresses for Unknown Individual

  • 3373 COMMERCE PKWY

    SUITE 2

    WOOSTER, OH 446917130

    Phone: (330) 804-9712

    Fax: (330) 804-9717

    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 2 Open Payments records for all available years, with a total value of $45.

Total Amount is formed as General ($45) + Research ($0) + Ownership ($0) = $45.

Last reported payment date: 2023-08-07 • Largest payer in this snapshot: Medtronic, Inc. ($23).

Total Amount

$45

General + Research + Ownership

Payments

2

Total payment records

General Amount

$45

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-08-07

Latest reported date

Top Companies

Largest payers in this snapshot

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
J3301Injection, triamcinolone acetonide, not otherwise specified, 10 mg44946$0
99213Established patient office or other outpatient visit, 20-29 minutes229146$0
99214Established patient office or other outpatient visit, 30-39 minutes10490$0
73564X-ray of knee, 4 or more views9677$0
99204New patient office or other outpatient visit, 45-59 minutes5757$0
View full utilization report →

Insurance plans in this area (ZIP 44691)

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Provider's Procedures

Unknown Individual performs procedures in Orthopaedic Surgery Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
ORTHOPEDIC SURGERYOH20610Aspiration and/or injection of large joint or joint capsule211103
ORTHOPEDIC SURGERYOH27447Repair of knee joint4240
ORTHOPEDIC SURGERYOH73562X-ray of knee, 3 views15194

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: 6204733355View full group profile
NameSpecialtyState
-OH
Physical Therapist In Private PracticeOH
Physical Therapist In Private PracticeOH
-OH
Physical Therapist In Private PracticeOH
Physical Therapist In Private PracticeOH
-OH
Physical Therapist In Private PracticeOH

Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1821097650 on file in the registry.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Orthopaedic Surgery Physician in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Wooster, Ohio.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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