Unknown Individual – Pediatric Pathology Physician, NPI 1013906874

Unknown Individual is a healthcare provider. based in Winchester, Virginia. specializing in Pediatric Pathology Physician. They hold a License No. 0101044472 (VA). The NPI Number for Unknown Individual is 1013906874

Main info

Organization
Inactive
41 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1013906874
Phone
(540) 678-0939
Address
455 BACK MOUNTAIN RD
Deactivation Date
27 November 2025

Doctor Profile

Medical School Name
UNIVERSITY OF FLORIDA COLLEGE OF MEDICINE
Secondary Phone
5405368790
Graduation Year
1985 (41 years ago)
PAC ID
3870654726
Group Practice PAC ID
6204824519
Professional Enrollment ID
I20100511000804
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 2999 Back Mountain Road, 2999, Back Mountain Road, Rosenberger, Winchester, Frederick County, Virginia, 22602, United States

    WINCHESTER, VA 226021619

    Phone: (540) 678-0939

    Type: Mailing

  • ValleyHealth Winchester Medical Center, 1840, Amherst Street, Winchester, Winchester City, Virginia, 22601, United States

    WINCHESTER, VA 226012808

    Phone: (540) 536-8790

    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 $43.

Total Amount is formed as General ($43) + Research ($0) + Ownership ($0) = $43.

Last reported payment date: 2024-12-04 • Largest payer in this snapshot: Abbott Laboratories ($43).

Total Amount

$43

General + Research + Ownership

Payments

3

Total payment records

General Amount

$43

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-04

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Abbott Laboratories$43
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 22602)

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Provider's Procedures

Unknown Individual performs procedures in Pediatric Pathology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PATHOLOGYVA88304Pathology examination of tissue using a microscope, moderately low complexity3734
PATHOLOGYVA88342Tissue or cell analysis by immunologic technique4643

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: 6204824519View full group profile
NameSpecialtyState
-VA

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 1013906874 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.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Pediatric Pathology Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Winchester, Virginia?
For routing, start with Winchester, Virginia for Unknown Individual, then verify phone and hours locally.
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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