Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1639170145

Unknown Individual is a healthcare provider. based in Stratford, Connecticut. specializing in Certified Registered Nurse Anesthetist. They hold a License No. 522858 (NY). The NPI Number for Unknown Individual is 1639170145

Main info

Organization
Inactive
45 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1639170145
Phone
(203) 260-4519
Address
7365 Main St # 310
Deactivation Date
12 June 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2037397118
Graduation Year
1981 (45 years ago)
PAC ID
2769446889
Group Practice PAC ID
4789597691
Professional Enrollment ID
I20110110000010
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

Provider Addresses for Unknown Individual

  • 7365 Main St # 310

    Stratford, CT 066141300

    Phone: (203) 260-4519

    Type: Location

  • 43, Kensico Drive, Mount Kisco, Westchester, New York, 10549, United States

    2ND FLOOR

    MOUNT KISCO, NY 105491009

    Phone: (914) 666-8866

    Fax: (914) 666-6777

    Type: Mailing

  • Putnam Hospital Center, 670, Stoneleigh Avenue, Carmel Hills, Carmel, Town of Carmel, Putnam County, New York, 10512, United States

    PUTNAM HOSPITAL

    CARMEL, NY 105123997

    Phone: (845) 279-5711

    Type: Location

  • 23 TRAILSIDE DR

    MONROE, CT 064681479

    Phone: (203) 913-3500

    Type: Mailing

  • 24 HOSPITAL AVE

    DANBURY, CT 068106099

    Phone: (203) 739-7856

    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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00142Anesthesia for lens surgery2525$0
01630Anesthesia for other procedure on top of arm bone and shoulder joint1111$0
View full utilization report →

Insurance plans in this area (ZIP 06614)

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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: 4789597691View full group profile

Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1639170145 if you need a stable reference for Unknown Individual.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Connecticut?
You will see Stratford, Connecticut on file for Unknown Individual alongside any extra practice locations.
What if Stratford, Connecticut seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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