Unknown Individual – Surgery Physician, NPI 1578536967

Unknown Individual is a healthcare provider. based in Virginia beach, Virginia. specializing in Surgery Physician. They hold a License No. 0101015813 (VA). The NPI Number for Unknown Individual is 1578536967

Main info

Organization
Inactive
64 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1578536967
Phone
(757) 557-0300
Address
5589 GREENWICH RD
Deactivation Date
23 October 2025

Doctor Profile

Medical School Name
UNIVERSITY OF VIRGINIA SCHOOL OF MEDICINE
Secondary Phone
7572744000
Graduation Year
1962 (64 years ago)
PAC ID
9234279225
Group Practice PAC ID
9335183482
Professional Enrollment ID
I20091223000292
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

  • 5589, Greenwich Road, Greenwich, Kempsville Heights, Virginia Beach, Virginia, 23462, United States

    SUITE 100

    VIRGINIA BEACH, VA 234626565

    Phone: (757) 557-0300

    Fax: (757) 557-0321

    Type: Location

  • PO Box, adj, Main Road, Lot's Bridge, Upwell, King's Lynn and West Norfolk, Norfolk, East of England, England, PE14 9JA, United Kingdom

    NORFOLK, VA 235010936

    Phone: (757) 557-0300

    Fax: (757) 557-0321

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 4 Open Payments records for all available years, with a total value of $192.

Total Amount is formed as General ($192) + Research ($0) + Ownership ($0) = $192.

Last reported payment date: 2023-09-21 • Largest payer in this snapshot: Mentor Worldwide LLC ($123).

Total Amount

$192

General + Research + Ownership

Payments

4

Total payment records

General Amount

$192

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-09-21

Latest reported date

Top Companies

Largest payers in this snapshot

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 23462)

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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: 9335183482View full group profile
NameSpecialtyState
-VA

Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1578536967 is assigned to Unknown Individual under the national enumeration system.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Surgery Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Virginia Beach, Virginia for Unknown Individual; expand the address list for detail.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1578536967. Always confirm identity and privileges with the practice and licensing boards.

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