Unknown Individual – Physician Assistant, NPI 1982612958

Unknown Individual is a healthcare provider. based in Guilford, Connecticut. specializing in Physician Assistant. They hold a License No. 000226 (CT). The NPI Number for Unknown Individual is 1982612958

Main info

Organization
Inactive
36 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1982612958
Phone
(203) 458-8921
Address
28 SOUTH FAIR ST
Deactivation Date
23 June 2022

Doctor Profile

Medical School Name
YALE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
2036882471
Graduation Year
1990 (36 years ago)
PAC ID
1951300573
Group Practice PAC ID
9436061736
Professional Enrollment ID
I20061208000436
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

  • 28, South Fair Street, Guilford, South Central Connecticut Planning Region, Connecticut, 06437, United States

    GUILFORD, CT 06437

    Phone: (203) 458-8921

    Fax: (203) 789-3786

    Type: Mailing

  • Yale New Haven Hospital Saint Raphael Campus, 1450, Chapel Street, Dwight Street Historic District, New Haven, New Haven County, Connecticut, 06511, United States

    HOSPITAL ST RAPHAEL

    NEW HAVEN, CT 06511

    Phone: (203) 789-3151

    Fax: (203) 789-3786

    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 06437)

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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: 9436061736View full group profile
NameSpecialtyState
Interventional Cardiology, Cardiovascular Disease (Cardiology)CT
H E M A T O L O G Y/ O N C O L O G YCT
Internal Medicine, NephrologySC
-CT
-NC
Internal MedicineCT
-CT
Cardiac SurgeryCT
-CT
-CT

Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1982612958.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's primary classification?
Physician Assistant is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Guilford, Connecticut in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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