Unknown Individual – Psychiatry Physician, NPI 1215094693

Unknown Individual is a healthcare provider. based in Rockport, Maine. specializing in Psychiatry Physician. They hold a License No. 014931 (ME). The NPI Number for Unknown Individual is 1215094693

Main info

Organization
Inactive
49 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1215094693
Phone
(207) 596-8633
Address
6 GLEN COVE DR
Deactivation Date
16 December 2022

Doctor Profile

Medical School Name
BAYLOR COLLEGE OF MEDICINE
Secondary Phone
2079736470
Graduation Year
1977 (49 years ago)
PAC ID
9638109150
Group Practice PAC ID
7719878495
Professional Enrollment ID
I20050815000881
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

  • 6, Glen Cove Drive, Rockport, Knox County, Maine, 04856, United States

    ROCKPORT, ME 048564240

    Phone: (207) 596-8633

    Fax: (207) 593-5316

    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 04856)

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Provider's Procedures

Unknown Individual performs procedures in Psychiatry Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PSYCHIATRYME90792Psychiatric diagnostic evaluation with medical services2624

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: 7719878495View full group profile
NameSpecialtyState
DR. CLIFFORD M SINGER (M.D.)
Psychiatry, NeurologyME
DANHONG ZHAO (M.D.)
P S Y C H I A T R YSD
REBECCA F MARSHALL (PMH NP)
Nurse PractitionerME
DR. TIMOTHY ROCKCRESS (MD)
-ME
JAMES THOMAS (PH.D.)
Clinical PsychologistME
MRS. JEANETTE B. ROGERS (LCSW)
Clinical Social WorkerME
DR. NADIA MENDIOLA
P S Y C H I A T R YTX
DAVID PRESCOTT (PHD)
-ME
JOSHUA P. NEWMAN (M.D.)
P S Y C H I A T R YME
LEWIS E MEHL-MADRONA
Family Practice, PsychiatryME

Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1215094693 as the unique 10-digit identifier.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Psychiatry Physician in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Rockport, Maine.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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