Unknown Individual – Physical Therapist, NPI 1790766715

Unknown Individual is a healthcare provider. based in Middletown, Delaware. specializing in Physical Therapist. They hold a License No. J10001798 (DE). The NPI Number for Unknown Individual is 1790766715

Main info

Organization
Inactive
32 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1790766715
Phone
(302) 376-4315
Address
432 E MAIN ST
Deactivation Date
20 January 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3024497792
Graduation Year
1994 (32 years ago)
PAC ID
1557351194
Group Practice PAC ID
0749283083
Professional Enrollment ID
I20040514001123
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

  • 432, East Main Street, South Farms, Middletown, Lower Connecticut River Valley Planning Region, Connecticut, 06457, United States

    MIDDLETOWN, DE 197091462

    Phone: (302) 376-4315

    Fax: (302) 376-4318

    Mailing address matches the actual address.

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 19709)

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Provider's Procedures

Unknown Individual performs procedures in Physical Therapist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYDE97001Physical therapy evaluation7673
PHYSICAL THERAPYDE97140Manual (physical) therapy techniques to 1 or more regions, each 15 minutes814181

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: 0749283083View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeNC
-DE
Physical Therapist In Private PracticeIL
-PA
Physical Therapist In Private PracticePA
-DE
-PA
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeDE
-MD

Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?
The NPI 1790766715 uniquely identifies Unknown Individual in U.S. healthcare data.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Physical Therapist. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Middletown, Delaware 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.

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