Unknown Individual – Diagnostic Radiology Physician, NPI 1285610907

Unknown Individual is a healthcare provider. based in East hartford, Connecticut. specializing in Diagnostic Radiology Physician. They hold a License No. 246222 (MA). The NPI Number for Unknown Individual is 1285610907

Main info

Organization
Inactive
55 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1285610907
Phone
(860) 289-3375
Address
111 FOUNDERS PLZ
Deactivation Date
24 July 2025

Doctor Profile

Medical School Name
COLUMBIA UNIVERSITY COLLEGE OF PHYSICIANS AND SURGEONS
Secondary Phone
8602893375
Graduation Year
1971 (55 years ago)
PAC ID
6709780513
Group Practice PAC ID
4183649098
Professional Enrollment ID
I20051013000397
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

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

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Provider Addresses for Unknown Individual

  • 111 FOUNDERS PLZ

    SUITE 400

    EAST HARTFORD, CT 061083212

    Phone: (860) 289-3375

    Fax: (860) 783-5733

    Type: Mailing

  • Seymour Street, Manchester, Hartford County, Connecticut, 06042, United States

    HARTFORD, CT 061065509

    Phone: (860) 289-3375

    Fax: (860) 783-5733

    Type: Location

  • 111 Founders Plz

    Suite 400

    East Hartford, CT 061083212

    Phone: (860) 289-3375

    Fax: (860) 783-5733

    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.

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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 06108)

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Provider's Procedures

Unknown Individual performs procedures in Diagnostic Radiology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DIAGNOSTIC RADIOLOGYCT71010X-ray of chest, 1 view, front651612
DIAGNOSTIC RADIOLOGYCT74177CT scan of abdomen and pelvis with contrast1713
DIAGNOSTIC RADIOLOGYCT93971Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers3737

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: 4183649098View full group profile
NameSpecialtyState
MRINAL S MALI (M.D.)
Diagnostic RadiologyMA
PALLAVI NADENDLA (M.D.)
Diagnostic Radiology, Interventional RadiologyNY
DR. RONALD J. ROSENBERG (M.D.)
Nuclear Medicine, Endocrinology, Internal MedicineCT
DR. STACEY A BASS (MD, PHD)
Diagnostic Radiology, Interventional RadiologyCT
DR. WERNER ROSSHIRT (M.D.)
-CT
GARY W KRAVETZ (MD)
-CT
ABIGAIL LEIGH KLUCZEWSKI (PA-C)
Physician AssistantCT
DR. ANAL C PATEL (M.D.)
Diagnostic RadiologyCT
GREGORY T. TURNER (M.D.)
-CT
JOSHUA KALLEN (M.D.)
Diagnostic RadiologyCT

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 1285610907.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Diagnostic Radiology Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to East Hartford, Connecticut?
If you are local to East Hartford, Connecticut, Unknown Individual may be relevant to your search.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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