Unknown Individual – Internal Medicine Physician, NPI 1871583633

Unknown Individual is a healthcare provider. based in Warren, Ohio. specializing in Internal Medicine Physician. They hold a License No. 35-03-4180 (OH). The NPI Number for Unknown Individual is 1871583633

Main info

Organization
Inactive
64 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1871583633
Phone
(330) 856-1164
Address
8052 E MARKET ST
Deactivation Date
26 July 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3308561164
Graduation Year
1962 (64 years ago)
PAC ID
0749325249
Professional Enrollment ID
I20100309000359
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

  • East Market Street, Colonial Village, Warren, Trumbull County, Ohio, 44482, United States

    WARREN, OH 444842258

    Phone: (330) 856-1164

    Fax: (330) 856-7422

    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 1 Open Payments records for all available years, with a total value of $32.

Total Amount is formed as General ($32) + Research ($0) + Ownership ($0) = $32.

Last reported payment date: 2023-02-03 • Largest payer in this snapshot: ABBVIE INC. ($32).

Total Amount

$32

General + Research + Ownership

Payments

1

Total payment records

General Amount

$32

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-02-03

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$32
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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 44484)

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Provider's Procedures

Unknown Individual performs procedures in Internal Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
INTERNAL MEDICINEOH93010Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report8754

Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1871583633.
Does inactive mean outdated data for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Internal Medicine Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Warren, 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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