Unknown Individual – Psychiatric/Mental Health Nurse Practitioner, NPI 1013387067

Unknown Individual is a healthcare provider. based in New haven, Connecticut. specializing in Psychiatric/Mental Health Nurse Practitioner. They hold a License No. 113935 (CT). The NPI Number for Unknown Individual is 1013387067

Main info

Organization
Inactive
11 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1013387067
Phone
(203) 671-4014
Address
179 CHESTNUT ST
Deactivation Date
19 July 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2036889711
Graduation Year
2015 (11 years ago)
PAC ID
3870899420
Group Practice PAC ID
9436061736
Professional Enrollment ID
I20160309000175
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 179 CHESTNUT ST

    APARTMENT 2L

    NEW HAVEN, CT 065114972

    Phone: (203) 671-4014

    Type: Mailing

  • 184 LIBERTY ST

    NEW HAVEN, CT 065191625

    Phone: (203) 688-9907

    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 06511)

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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: 9436061736View full group profile
NameSpecialtyState
Interventional Cardiology, Cardiovascular Disease (Cardiology)CT
H E M A T O L O G Y/ O N C O L O G YCT
Internal Medicine, NephrologySC
-CT
-NC
Internal MedicineCT
-CT
Cardiac SurgeryCT
-CT
Physician AssistantCT

Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1013387067.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with New Haven?
Public fields place Unknown Individual around New Haven, Connecticut. Always confirm the exact site before visiting.
Can I trust this NPI listing for Unknown Individual?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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