Unknown Individual – Family Medicine Physician, NPI 1023017035

Unknown Individual is a healthcare provider. based in Belfast, Maine. specializing in Family Medicine Physician. They hold a License No. 02001769A (IN). The NPI Number for Unknown Individual is 1023017035

Main info

Organization
Inactive
31 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1023017035
Phone
Not provided
Address
PO BOX 13059
Deactivation Date
14 May 2021

Doctor Profile

Medical School Name
DES MOINES UNIVERSITY OF OSTEOPATHIC MEDICINE AND HEALTH SCIENCES
Secondary Phone
8128978500
Graduation Year
1995 (31 years ago)
PAC ID
6305845587
Group Practice PAC ID
1153493341
Professional Enrollment ID
I20061218000007
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

  • PO BOX 13059

    BELFAST, ME 049154021

    Phone:

    Type: Mailing

  • 3277 LIBERTY BLVD STE A

    BOONVILLE, IN 476019659

    Phone: (812) 897-8500

    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 04915)

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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: 1153493341View full group profile
NameSpecialtyState
-IN
O B S T E T R I C S/ G Y N E C O L O G YME
Family PracticeME
-ME
P O D I A T R YME
N E U R O L O G YIN
Cardiac Electrophysiology, Cardiovascular Disease (Cardiology)CA
Hospitalist, Family Practice, Family PracticeFL
Nurse PractitionerIN
Hospitalist, Internal MedicineIN

Reviews

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Frequently asked questions

What is the standard ID for Unknown Individual in the U.S.?
In the U.S., Unknown Individual is identified by NPI 1023017035.
Does inactive mean outdated data 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 Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Belfast, Maine. Check all listed addresses for suites or satellite offices.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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