Unknown Individual – Surgical Physician Assistant, NPI 1205287679

Unknown Individual is a healthcare provider. based in Hyannis, Massachusetts. specializing in Surgical Physician Assistant. The NPI Number for Unknown Individual is 1205287679

Main info

Organization
Inactive
52 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1205287679
Phone
(508) 771-1800
Address
27 PARK ST
Deactivation Date
17 January 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5087462000
Graduation Year
1974 (52 years ago)
PAC ID
2668764259
Group Practice PAC ID
1254321086
Professional Enrollment ID
I20160629002400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience5
Completeness75
Years active:0State licenses:0Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Cape Cod Hospital, 27, Park Street, Hyannis, Barnstable, Barnstable County, Massachusetts, 02601, United States

    HYANNIS, MA 026015230

    Phone: (508) 771-1800

    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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02601)

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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: 1254321086View full group profile
NameSpecialtyState
H E M A T O L O G Y/ O N C O L O G YMA
Physician AssistantMA
Certified Nurse Midwife (Cnm)MA
Physician AssistantMO
Nurse PractitionerMA
Thoracic SurgeryMA
H E M A T O L O G Y/ O N C O L O G YMA
-MA
General SurgeryMA
Nurse PractitionerMA

Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1205287679 as the unique 10-digit identifier.
Is Unknown Individual still active if the NPI shows inactive?
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 Surgical Physician Assistant in the directory — Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Hyannis, Massachusetts as the reference point for Unknown Individual, then confirm.
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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