Unknown Individual – Diagnostic Radiology Physician, NPI 1063428480

Unknown Individual is a healthcare provider. based in North chesterfield, Virginia. specializing in Diagnostic Radiology Physician. They hold a License No. 232084 (NY). The NPI Number for Unknown Individual is 1063428480

Main info

Organization
Inactive
27 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1063428480
Phone
(804) 272-8806
Address
2602 BUFORD RD
Deactivation Date
7 August 2025

Doctor Profile

Medical School Name
MIDWESTERN UNIVERSITY, CHICAGO COLLEGE OF OSTEOPATHIC MED
Secondary Phone
8044830400
Graduation Year
1999 (27 years ago)
PAC ID
3577860063
Group Practice PAC ID
9830088434
Professional Enrollment ID
I20160329000431
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

  • 2602, Buford Road, Grand Summit, Bon Air, Chesterfield County, Virginia, 23235, United States

    NORTH CHESTERFIELD, VA 232353422

    Phone: (804) 272-8806

    Fax: (804) 272-2909

    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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
70450Ct scan head or brain without contrast315301$0
71045X-ray of chest, 1 view307299$0
71275Ct scan of blood vessels of chest with contrast197196$0
74177Ct scan of abdomen and pelvis with contrast126126$0
72125Ct scan of upper spine without contrast115114$0
View full utilization report →

Insurance plans in this area (ZIP 23235)

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Provider's Procedures

Unknown Individual performs procedures in Diagnostic Radiology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DIAGNOSTIC RADIOLOGYVA71010X-ray of chest, 1 view, front10188

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: 9830088434View full group profile
NameSpecialtyState
Diagnostic RadiologyVA
Diagnostic Radiology, Interventional RadiologyVA
Diagnostic RadiologyVA
Diagnostic RadiologyVA
Diagnostic RadiologyVA
Diagnostic RadiologyVA
Diagnostic RadiologyVA
Diagnostic RadiologyVA
Diagnostic RadiologyVA
-VA

Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1063428480 is assigned to Unknown Individual under the national enumeration system.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What kind of provider is Unknown Individual?
The page reflects Diagnostic Radiology Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Virginia?
You will see North Chesterfield, Virginia on file for Unknown Individual alongside any extra practice locations.
How can I contact Unknown Individual?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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