Unknown Individual – Psychiatry Physician, NPI 1619062700

Psychiatry Physician

Unknown Individual is a healthcare provider. based in Windsor, Connecticut. specializing in Psychiatry Physician. They hold a License No. 011815 (CT). The NPI Number for Unknown Individual is 1619062700

Main info

Organization

Inactive

65 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1619062700

Phone

(890) 731-5522

Address

995 DAY HILL RD

Deactivation Date

5 March 2026

Doctor Profile

Medical School Name

OTHER

Secondary Phone

8602436584

Graduation Year

1961 (65 years ago)

PAC ID

1850288408

Group Practice PAC ID

5597652149

Professional Enrollment ID

I20040524000735

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

995, Day Hill Road, Windsor, Hartford County, Connecticut, 06095, United States
WINDSOR, CT 060951722
Phone: (890) 731-5522
Fax: (860) 731-5536
Type: Mailing
444, Center Street, Hilliardville, Manchester, Hartford County, Connecticut, 06040, United States
MANCHESTER, CT 060403926
Phone: (860) 646-3888
Fax: (860) 645-4132
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 06095)

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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: 5597652149View full group profile

Name	Specialty	State
JODI SAMMARTINO (LCSW)	Clinical Social Worker	CT
AMY M ST. PIERRE (LADC, LPC)	Mental Health Counselor	CT
CHRYSTAL ALINE CANOVA (LCSW)	Clinical Social Worker	CT
MS. HEIDI MARIE SMOLKA (APRN)	Nurse Practitioner	CT
DIANA GIORDANO	Mental Health Counselor	CT
MARIAH LANGLOIS	Mental Health Counselor	CT
CATHERINE RECKMEYER	-	CT
JOHN JACOB	-	CT
VICTOR R ACEVEDO	Clinical Social Worker	CT
Unknown Individual	-	CT