Unknown Individual – Physician Assistant, NPI 1396786018

Unknown Individual is a healthcare provider. based in Belfast, Maine. specializing in Physician Assistant. They hold a License No. PA833 (ME). The NPI Number for Unknown Individual is 1396786018

Main info

Organization
Inactive
25 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1396786018
Phone
(207) 338-2500
Address
118 NORTHPORT AVE
Deactivation Date
11 October 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2001 (25 years ago)
PAC ID
3678544079
Group Practice PAC ID
7517860588
Professional Enrollment ID
I20040802000069
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

  • Waldo County General Hospital, 118, Northport Avenue, Belfast, Waldo County, Maine, 04915, United States

    POB 287

    BELFAST, ME 049156009

    Phone: (207) 338-2500

    Fax: (207) 338-6029

    Type: Mailing

  • Eastern Maine Medical Center, 489, State Street, Bangor, Penobscot County, Maine, 04401, United States

    VASCULAR CARE OF MAINE

    BANGOR, ME 044016616

    Phone: (207) 973-6670

    Fax: (207) 973-5226

    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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99231Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes3414$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes1711$0
View full utilization report →

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: 7517860588View full group profile

Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1396786018 is assigned to Unknown Individual under the national enumeration system.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
What kind of provider is Unknown Individual?
The page reflects Physician Assistant for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Belfast, Maine for Unknown Individual; download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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