Unknown Individual – Internal Medicine Physician, NPI 1013990837

Unknown Individual is a healthcare provider. based in New haven, Connecticut. specializing in Internal Medicine Physician. They hold a License No. 034339 (CT). The NPI Number for Unknown Individual is 1013990837

Main info

Organization
Inactive
34 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1013990837
Phone
(203) 688-2471
Address
789 HOWARD AVE
Deactivation Date
8 March 2023

Doctor Profile

Medical School Name
CLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
Secondary Phone
2036882433
Graduation Year
1992 (34 years ago)
PAC ID
7315929288
Group Practice PAC ID
9436061736
Professional Enrollment ID
I20040603001194
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

  • Primary Care Center, 789, Howard Avenue, New Haven, New Haven County, Connecticut, 06511, United States

    YNHH - PRIMARY CARE CENTER

    NEW HAVEN, CT 065191304

    Phone: (203) 688-2471

    Fax: (203) 688-4516

    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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06519)

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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
-CT
-NC
Internal MedicineCT
-CT
-CT
-CT
Physician AssistantCT
-CT

Reviews

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Frequently asked questions

What is the standard ID for Unknown Individual in the U.S.?
In the U.S., Unknown Individual is identified by NPI 1013990837.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
How should patients interpret Unknown Individual's specialty?
The extract shows Internal Medicine Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with New Haven, Connecticut in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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