Unknown Individual – Surgery Physician, NPI 1407883135

Unknown Individual is a healthcare provider. based in Biddeford, Maine. specializing in Surgery Physician. They hold a License No. MD18571 (ME). The NPI Number for Unknown Individual is 1407883135

Main info

Organization
Inactive
54 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1407883135
Phone
(207) 282-9080
Address
1 MEDICAL CENTER DR
Deactivation Date
23 August 2021

Doctor Profile

Medical School Name
JEFFERSON MEDICAL COLLEGE OF THOMAS JEFFERSON UNIVERSITY
Secondary Phone
-
Graduation Year
1972 (54 years ago)
PAC ID
9335204775
Group Practice PAC ID
7517860588
Professional Enrollment ID
I20091111000418
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

  • Southern Maine Health Care, 1, Medical Center Drive, Biddeford, York County, Maine, 04005, United States

    BIDDEFORD, ME 040059422

    Phone: (207) 282-9080

    Fax: (207) 284-2631

    Type: Mailing

  • 9, Healthcare Drive, Biddeford, York County, Maine, 04005, United States

    SUITE 204

    BIDDEFORD, ME 040059449

    Phone: (207) 284-2630

    Fax: (207) 284-2631

    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 04005)

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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

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1407883135.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Surgery Physician in the directory — Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Biddeford?
Unknown Individual currently maps to Biddeford, Maine in this extract.
Does Unknown Individual accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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