Unknown Individual – Emergency Medicine Physician, NPI 1144367913

Unknown Individual is a healthcare provider. based in Bridgeport, Connecticut. specializing in Emergency Medicine Physician. They hold a License No. 037409 (CT). The NPI Number for Unknown Individual is 1144367913

Main info

Organization
Inactive
30 Years Of Experience
Name
Unknown Individual
NPI
1144367913
Phone
(203) 576-5177
Address
2800 MAIN ST
Deactivation Date
19 June 2024

Doctor Profile

Medical School Name
UNIVERSITY OF ROCHESTER SCHOOL OF MEDICINE AND DENTISTRY
Secondary Phone
2035165307
Graduation Year
1996 (30 years ago)
PAC ID
0042351918
Group Practice PAC ID
7214107515
Professional Enrollment ID
I20100114000329
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

  • Daniel T Banks Health Science Library, 2800, Main Street, Bridgeport, Fairfield County, Connecticut, 06606, United States

    ST. VINCENT MEDICAL CENTER

    BRIDGEPORT, CT 066064201

    Phone: (203) 576-5177

    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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes4038$0
99204New patient office or other outpatient visit, 45-59 minutes3434$0
87635Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen1919$0
87631Detection test by nucleic acid for multiple types of respiratory virus, multiple types or subtypes, 3-5 targets1717$0
99213Established patient office or other outpatient visit, 20-29 minutes1211$0
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Insurance plans in this area (ZIP 06606)

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Provider's Procedures

Unknown Individual performs procedures in Emergency Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
EMERGENCY MEDICINECT81002Urinalysis, manual test2928

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: 7214107515View full group profile
NameSpecialtyState
Emergency MedicineNY
-CT
-CT
Nurse PractitionerCT
Nurse PractitionerNY
-PA
Nurse PractitionerCT
Nurse PractitionerCT
Physician AssistantCT
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 1144367913.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Emergency Medicine Physician in the directory — Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Bridgeport?
Public fields place Unknown Individual around Bridgeport, Connecticut. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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