Unknown Individual – Chiropractor, NPI 1104906163

Unknown Individual is a healthcare provider. based in Newton, Massachusetts. specializing in Chiropractor. They hold a License No. 612 (MA). The NPI Number for Unknown Individual is 1104906163

Main info

Organization
Inactive
45 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1104906163
Phone
(617) 332-9080
Address
851 BEACON ST
Deactivation Date
27 February 2025

Doctor Profile

Medical School Name
LOGAN COLLEGE OF CHIROPRACTIC
Secondary Phone
6173329080
Graduation Year
1981 (45 years ago)
PAC ID
6507939063
Group Practice PAC ID
4587730817
Professional Enrollment ID
I20080717000248
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

  • 849;851, Beacon Street, Newton Centre, Newton, Middlesex County, Massachusetts, 02159, United States

    NEWTON, MA 024591822

    Phone: (617) 332-9080

    Fax: (617) 332-8735

    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
98941Chiropractic manipulative treatment, 3-4 spinal regions2,108265$0
98940Chiropractic manipulative treatment, 1-2 spinal regions33845$0
View full utilization report →

Insurance plans in this area (ZIP 02459)

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Provider's Procedures

Unknown Individual performs procedures in Chiropractor. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
CHIROPRACTICMA98940Chiropractic manipulative treatment, 1-2 spinal regions23326
CHIROPRACTICMA98942Chiropractic manipulative treatment, 5 spinal regions54578

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: 4587730817View full group profile
NameSpecialtyState
DR. KAREN MARIE KOLARIK (D.C.)
-MA

Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1104906163 is assigned to Unknown Individual under the national enumeration system.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Chiropractor. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Newton, Massachusetts because that is what the record indicates for Unknown Individual.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1104906163. Always confirm identity and privileges with the practice and licensing boards.

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