Unknown Individual – Hospitalist Physician, NPI 1083671218

Unknown Individual is a healthcare provider. based in Agawam, Massachusetts. specializing in Hospitalist Physician. They hold a License No. 45782 (MA). The NPI Number for Unknown Individual is 1083671218

Main info

Organization
Inactive
49 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1083671218
Phone
(413) 789-8600
Address
230 MAIN ST
Deactivation Date
5 June 2025

Doctor Profile

Medical School Name
TUFTS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
4137361458
Graduation Year
1977 (49 years ago)
PAC ID
8921041617
Group Practice PAC ID
2860536919
Professional Enrollment ID
I20050603000383
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

  • 230, Main Street, Agawam, Hampden County, Massachusetts, 01001, United States

    AGAWAM, MA 010011838

    Phone: (413) 789-8600

    Fax: (413) 789-8048

    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)

CMS reports 2 Open Payments records for all available years, with a total value of $57.

Total Amount is formed as General ($57) + Research ($0) + Ownership ($0) = $57.

Last reported payment date: 2024-03-26 • Largest payer in this snapshot: Braeburn Inc. ($57).

Total Amount

$57

General + Research + Ownership

Payments

2

Total payment records

General Amount

$57

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-03-26

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Braeburn Inc.$57
View all Open Payments →|Open Payments Risk Radar →

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
99214Established patient office or other outpatient visit, 30-39 minutes17657$0
99213Established patient office or other outpatient visit, 20-29 minutes4319$0
View full utilization report →

Insurance plans in this area (ZIP 01001)

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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: 2860536919View full group profile
NameSpecialtyState
Mental Health CounselorME
-MA
Nurse PractitionerMA
Nurse PractitionerMA
Nurse PractitionerMA
Internal MedicineMA
Nurse PractitionerMA
Physician AssistantMA
-MA
Nurse PractitionerMA

Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1083671218 — is the standard way to identify this listing.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Hospitalist Physician. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Agawam, Massachusetts; more addresses can appear in NPPES.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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