Unknown Individual – Gastroenterology Physician, NPI 1811996887

Unknown Individual is a healthcare provider. based in Camp hill, Pennsylvania. specializing in Gastroenterology Physician. They hold a License No. MD0071066L (PA). The NPI Number for Unknown Individual is 1811996887

Main info

Organization
Inactive
29 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1811996887
Phone
(717) 761-0930
Address
423 N 21ST ST
Deactivation Date
10 April 2025

Doctor Profile

Medical School Name
HAHNEMANN UNIVERSITY COLLEGE OF MEDICINE
Secondary Phone
7177610930
Graduation Year
1997 (29 years ago)
PAC ID
4981677291
Group Practice PAC ID
5799769139
Professional Enrollment ID
I20040816000654

Contacts

Secure Messaging
dmize18132@directmsg.bmctotalcare.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness85
Years active:0State licenses:2Other namesUpdated within 12 months

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Provider Addresses for Unknown Individual

  • 423, North 21st Street, Camp Hill, Cumberland County, Pennsylvania, 17011, United States

    SUITE 100

    CAMP HILL, PA 170112207

    Phone: (717) 761-0930

    Fax: (717) 761-0465

    Type: Location

  • PO BOX 6048

    BEND, OR 977086048

    Phone: (541) 382-4900

    Fax: (541) 706-2398

    Type: Mailing

  • 1501 NE MEDICAL CENTER DR

    BEND, OR 977016051

    Phone: (541) 382-4900

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $70.

Total Amount is formed as General ($70) + Research ($0) + Ownership ($0) = $70.

Last reported payment date: 2024-04-25 • Largest payer in this snapshot: Regeneron Healthcare Solutions, Inc. ($36).

Total Amount

$70

General + Research + Ownership

Payments

3

Total payment records

General Amount

$70

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-04-25

Latest reported date

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
43239Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope194187$0
45385Removal of polyps or growths of large bowel using an endoscope with mechanical snare178176$0
99214Established patient office or other outpatient visit, 30-39 minutes9076$0
45380Biopsy of large bowel using a flexible endoscope7777$0
43248Insertion of guide wire with dilation of esophagus using a flexible endoscope7670$0
View full utilization report →

Insurance plans in this area (ZIP 17011)

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Provider's Procedures

Unknown Individual performs procedures in Gastroenterology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
GASTROENTEROLOGYPA45378Diagnostic examination of large bowel using an endoscope2222
GASTROENTEROLOGYPA45385Removal of polyps or growths of large bowel using an endoscope6464

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: 5799769139View full group profile
NameSpecialtyState
Physician AssistantPA
Gastroenterology, Internal MedicinePA
G A S T R O E N T E R O L O G YPA
Internal Medicine, GastroenterologyPA
Physician AssistantPA
Gastroenterology, Internal MedicinePA
Physician AssistantPA
-PA
-PA
P A T H O L O G YPA

Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1811996887 on file in the registry.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Gastroenterology Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Camp Hill, Pennsylvania.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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