Unknown Individual – Internal Medicine Physician, NPI 1851311435

Unknown Individual is a healthcare provider. based in Wethersfield, Connecticut. specializing in Internal Medicine Physician. They hold a License No. 045552 (CT). The NPI Number for Unknown Individual is 1851311435

Main info

Organization
Inactive
49 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1851311435
Phone
(860) 263-0253
Address
30 JORDAN LN
Deactivation Date
20 April 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8602460500
Graduation Year
1977 (49 years ago)
PAC ID
0648278531
Group Practice PAC ID
2668463985
Professional Enrollment ID
I20080111000319
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

  • Jordan Lane, Wethersfield, Hartford County, Connecticut, 06109, United States

    WETHERSFIELD, CT 061091278

    Phone: (860) 263-0253

    Fax: (860) 263-0262

    Type: Mailing

  • 893, Main Street, Central Avenue–Center Cemetery Historic District, East Hartford, Capitol Planning Region, Connecticut, 06108, United States

    SUITE 202

    EAST HARTFORD, CT 061082292

    Phone: (860) 528-4124

    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 06109)

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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: 2668463985View full group profile
NameSpecialtyState
Internal Medicine, Cardiovascular Disease (Cardiology)CT
Physician AssistantCT
Internal MedicineCT
Internal Medicine, Pulmonary DiseaseCT
Internal MedicineCT

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1851311435.
What does inactive NPI status mean for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Wethersfield, Connecticut in registry-derived data.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.