Unknown Individual – Internal Medicine Physician, NPI 1023009602

Unknown Individual is a healthcare provider. based in Springfield, Massachusetts. specializing in Internal Medicine Physician. They hold a License No. 257749 (MA). The NPI Number for Unknown Individual is 1023009602

Main info

Organization
Inactive
38 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1023009602
Phone
(413) 794-5700
Address
280 CHESTNUT STREET
Deactivation Date
15 May 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1988 (38 years ago)
PAC ID
2860472610
Group Practice PAC ID
5991602971
Professional Enrollment ID
I20140710000084
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

  • 280, Chestnut Street, Metro Center, Springfield, Hampden County, Massachusetts, 01103, United States

    2ND FL

    SPRINGFIELD, MA 011991001

    Phone: (413) 794-5700

    Type: Mailing

  • 57, Union Street, Westfield, Hampden County, Massachusetts, 01085-3899, United States

    WESTFIELD, MA 010852658

    Phone: (413) 572-6050

    Fax: (413) 568-1097

    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
99213Established patient office or other outpatient visit, 20-29 minutes206137$0
99442Telephone medical discussion with physician, 11-20 minutes12896$0
99214Established patient office or other outpatient visit, 30-39 minutes12294$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit5252$0
G0009Administration of pneumococcal vaccine4040$0
View full utilization report →

Insurance plans in this area (ZIP 01199)

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Provider's Procedures

Unknown Individual performs procedures in Internal Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
INTERNAL MEDICINEMA90670Pneumococcal vaccine for injection into muscle1414

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: 5991602971View full group profile
NameSpecialtyState
Emergency MedicineMA
Anesthesiology, Pain ManagementMA
Physician AssistantMA
-MA
-MA
-MA
-MA
Physician AssistantMA
Physician AssistantMA
General SurgeryMA

Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1023009602?
NPI 1023009602 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.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Internal Medicine Physician in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Springfield, Massachusetts.
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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