Unknown Individual – Cardiovascular Disease Physician, NPI 1184622193

Unknown Individual is a healthcare provider. based in Boston, Massachusetts. specializing in Cardiovascular Disease Physician. They hold a License No. 25MA02878400 (NJ). The NPI Number for Unknown Individual is 1184622193

Main info

Organization
Inactive
57 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1184622193
Phone
Not provided
Address
PO BOX 416457
Deactivation Date
17 April 2025

Doctor Profile

Medical School Name
BOSTON UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
9739715596
Graduation Year
1969 (57 years ago)
PAC ID
3476586959
Group Practice PAC ID
5890703177
Professional Enrollment ID
I20050915000022
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

  • PO Box 846028, Albany Street, Church Green, Financial District, Boston, Suffolk County, Massachusetts, 02284-6028, United States

    BOSTON, MA 022416457

    Phone:

    Type: Mailing

  • 435, South Street, Morris Township, Morris County, New Jersey, 07960, United States

    STE 100

    MORRISTOWN, NJ 079606440

    Phone: (973) 267-3944

    Fax: (973) 455-0399

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $51.

Total Amount is formed as General ($51) + Research ($0) + Ownership ($0) = $51.

Last reported payment date: 2024-06-17 • Largest payer in this snapshot: Novartis Pharmaceuticals Corporation ($51).

Total Amount

$51

General + Research + Ownership

Payments

3

Total payment records

General Amount

$51

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-06-17

Latest reported date

Top Companies

Largest payers in this snapshot

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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 02241)

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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: 5890703177View full group profile

Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1184622193 on file in the registry.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Cardiovascular Disease Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Boston?
Unknown Individual currently maps to Boston, Massachusetts in this extract.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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