Unknown Individual – Diagnostic Radiology Physician, NPI 1477570158

Unknown Individual is a healthcare provider. based in Kensington, Maryland. specializing in Diagnostic Radiology Physician. They hold a License No. MD040644 (DC). The NPI Number for Unknown Individual is 1477570158

Main info

Organization
Inactive
46 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1477570158
Phone
(301) 929-7100
Address
10810 CONNECTICUT AVE
Deactivation Date
8 May 2024

Doctor Profile

Medical School Name
GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
3016185700
Graduation Year
1980 (46 years ago)
PAC ID
1355247990
Group Practice PAC ID
3779495858
Professional Enrollment ID
I20040806000568
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:0State licenses:3Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Kaiser Permanente, 10810, Connecticut Avenue, Rock Creek Palisades, Kensington, Montgomery County, Maryland, 20895, United States

    KAISER PERMANENTE KENSINGTON MEDICAL CENTER

    KENSINGTON, MD 208952138

    Phone: (301) 929-7100

    Type: Location

  • East Jefferson Street, Croydon Park, Rockville, Montgomery County, Maryland, 20850-3827, United States

    KAISER PERMANENTE MEDICARE ENROLLMENT

    ROCKVILLE, MD 208524908

    Phone: (301) 816-2424

    Type: Mailing

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 20895)

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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: 3779495858View full group profile
NameSpecialtyState
BEVERLY HAGNER DARNELL (MD)
-MD
MS. PAULA GRACE (LCSW C)
-MD
SOWJANYA BHAGAVATULA (M.D)
Internal MedicineVA
DR. DAVID LENG (MD)
Family PracticeVA
DR. ROSHAN KALIM (VA)
Family PracticeVA
DR. SHERRY J WEINSTEIN MAYER (MD)
-MD
DR. STEVEN G CHATLIN (DPM)
-MD
DR. MEHRAN KHAJAVI (M.D.)
Family PracticeWV
CAROLYN SHERWOOD (PT)
-GA
MS. COLLEEN MARIE HEALEY (CRNP)
-MD

Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1477570158?
NPI 1477570158 belongs to Unknown Individual; compare other details if you need extra assurance.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Diagnostic Radiology Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Kensington?
Public fields place Unknown Individual around Kensington, Maryland. Always confirm the exact site before visiting.
Can I trust this NPI listing for Unknown Individual?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.