Unknown Individual – Dermatology Physician, NPI 1053377978

Unknown Individual is a healthcare provider. based in Cincinnati, Ohio. specializing in Dermatology Physician. They hold a License No. 35049276 (OH). The NPI Number for Unknown Individual is 1053377978

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1053377978
Phone
(513) 246-7800
Address
4600 WESLEY AVE
Deactivation Date
7 September 2022
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

  • Wesley Avenue, Betts-Longworth Historic District, West End, Cincinnati, Hamilton County, Ohio, 45203, United States

    N

    CINCINNATI, OH 452122298

    Phone: (513) 246-7800

    Fax: (513) 246-7852

    Type: Mailing

  • South Mason Montgomery Road, Mason, Warren County, Ohio, 45040, United States

    MASON, OH 450403706

    Phone: (513) 246-7000

    Fax: (513) 204-6355

    Type: Location

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 45212)

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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 1053377978.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Dermatology Physician. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Cincinnati, Ohio in our summary view.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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