Unknown Individual – Internal Medicine Physician, NPI 1003887001
Internal Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
PO BOX 355
GALES FERRY, CT 063350355
Phone: (860) 464-7274
Fax: (860) 464-7404
Type: Mailing
Route 12, Allyn Point, Gales Ferry, Ledyard, New London County, Connecticut, 06335, United States
SUITE 1
GALES FERRY, CT 063351800
Phone: (860) 464-7274
Fax: (860) 464-7404
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $179.
Total Amount is formed as General ($179) + Research ($0) + Ownership ($0) = $179.
Last reported payment date: 2023-09-19 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($96).
Total Amount
$179
General + Research + Ownership
Payments
8
Total payment records
General Amount
$179
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-09-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GlaxoSmithKline, LLC. | $96 |
| ABBVIE INC. | $29 |
| Boehringer Ingelheim Pharmaceuticals, Inc. | $19 |
| Amgen Inc. | $19 |
| Novo Nordisk Inc | $16 |
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 134 | 121 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 35 | 35 | $0 |
| 81002 | Urinalysis, manual test | 33 | 33 | $0 |
| 93000 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report | 33 | 33 | $0 |
| 82962 | Blood glucose (sugar) test performed by hand-held instrument | 33 | 32 | $0 |
Insurance plans in this area (ZIP 06335)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | CT | |
| - | CT | |
| Nurse Practitioner | IL |
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