Unknown Individual – Family Medicine Physician, NPI 1003832775

Unknown Individual is a healthcare provider. based in Coraopolis, Pennsylvania. specializing in Family Medicine Physician. They hold a License No. MD033170E (PA). The NPI Number for Unknown Individual is 1003832775

Main info

Organization
Inactive
44 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1003832775
Phone
(412) 269-0899
Address
1101 5TH AVE
Deactivation Date
11 February 2021

Doctor Profile

Medical School Name
CHICAGO COLLEGE OF MEDICINE AND SURGERY
Secondary Phone
7247288751
Graduation Year
1982 (44 years ago)
PAC ID
3375670797
Group Practice PAC ID
0042105678
Professional Enrollment ID
I20100416000091
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

  • Heritage Valley Health Center, 1101, 5th Avenue, Coraopolis, Allegheny County, Pennsylvania, 15108, United States

    CORAOPOLIS, PA 151081577

    Phone: (412) 269-0899

    Fax: (412) 749-6774

    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 15108)

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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 MEDICINEPA81002Urinalysis, manual test266176
FAMILY MEDICINEPA90670Pneumococcal vaccine for injection into muscle1616

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: 0042105678View full group profile
NameSpecialtyState
-PA
-PA
Physician AssistantPA
-PA
H O S P I T A L I S TPA
Interventional Cardiology, Cardiovascular Disease (Cardiology)PA
Physician AssistantNY
-NC
Internal MedicinePA
Family PracticePA

Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1003832775.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Coraopolis, Pennsylvania in the data we show; additional addresses may exist on the full record.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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