Unknown Individual – Psychiatry Physician, NPI 1013999093

Unknown Individual is a healthcare provider. based in Somerville, Massachusetts. specializing in Psychiatry Physician. They hold a License No. 46623 (MA). The NPI Number for Unknown Individual is 1013999093

Main info

Organization
Inactive
50 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1013999093
Phone
(617) 284-6252
Address
402A HIGHLAND AVE STE J
Deactivation Date
11 November 2023

Doctor Profile

Medical School Name
UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL
Secondary Phone
6172846252
Graduation Year
1976 (50 years ago)
PAC ID
5395773667
Professional Enrollment ID
I20050728000281
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

Provider Addresses for Unknown Individual

  • 402A HIGHLAND AVE STE J

    SOMERVILLE, MA 021442511

    Phone: (617) 284-6252

    Fax: (866) 397-7009

    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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90836Psychotherapy with evaluation and management visit, 45 minutes3912$0
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Insurance plans in this area (ZIP 02144)

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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
PSYCHIATRYMA90836Psychotherapy, 45 minutes with patient and/or family member7316

Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1013999093 — is the standard way to identify this listing.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Psychiatry Physician. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Somerville, Massachusetts; more addresses can appear in NPPES.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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