Unknown Individual – Specialist, NPI 1912931031

Unknown Individual is a healthcare provider. based in Presque isle, Maine. specializing in Specialist. They hold a License No. 013912 (ME). The NPI Number for Unknown Individual is 1912931031

Main info

Organization
Inactive
53 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1912931031
Phone
(207) 762-6027
Address
54 3RD ST
Deactivation Date
5 February 2026

Doctor Profile

Medical School Name
TUFTS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
2075322900
Graduation Year
1973 (53 years ago)
PAC ID
3375439292
Group Practice PAC ID
0042127946
Professional Enrollment ID
I20040226000336
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

  • South 3rd Street, Rogers City, Presque Isle County, Michigan, 49779, United States

    PRESQUE ISLE, ME 047692649

    Phone: (207) 762-6027

    Type: Mailing

  • North 2nd Street, Onaway, Presque Isle County, Michigan, 49765, United States

    PRESQUE ISLE, ME 047692637

    Phone: (207) 762-4641

    Fax: (207) 762-3336

    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 04769)

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Provider's Procedures

Unknown Individual performs procedures in Specialist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DIAGNOSTIC RADIOLOGYME71010X-ray of chest, 1 view, front6146
DIAGNOSTIC RADIOLOGYME71250CT scan chest1313
DIAGNOSTIC RADIOLOGYME74177CT scan of abdomen and pelvis with contrast1313

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: 0042127946View full group profile
NameSpecialtyState
STEPHAN O. BAMBERGER (MD)
Pain Management, Physical Medicine And Rehabilitation, Emergency MedicineME
KAITLIN ANNE KOPPEL (MSN, FNP-C)
Nurse PractitionerME
SHANNON L DANIELS (MD)
Diagnostic RadiologyMD
JON C OLDER (DO)
Internal MedicineME
BLAIRE A SIEFKEN (FNP)
Nurse PractitionerME
DR. RONA K GAZAWAY (M.D.)
Interventional Radiology, Nuclear Medicine, Diagnostic RadiologyKS
DR. BRETT SCHNEIDER (M.D.)
Diagnostic RadiologyNH
DR. SARA BANERJEE (M.D.)
Diagnostic RadiologyMN
HASSAN E ABOULEISH (MD)
-ME
KIMBERLY ANNE MAYS DE PEREZ (M.D.)
O B S T E T R I C S/ G Y N E C O L O G YME

Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1912931031; it appears in the national provider directory.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Other Service Providers. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Maine?
You will see Presque Isle, Maine on file for Unknown Individual alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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