Unknown Individual – Diagnostic Radiology Physician, NPI 1205883998

Unknown Individual is a healthcare provider. based in Lexington, Massachusetts. specializing in Diagnostic Radiology Physician. They hold a License No. 45737 (MA). The NPI Number for Unknown Individual is 1205883998

Main info

Organization
Inactive
58 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1205883998
Phone
(781) 863-8190
Address
122 E EMERSON RD
Deactivation Date
10 January 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7819793000
Graduation Year
1968 (58 years ago)
PAC ID
8123050440
Group Practice PAC ID
6406270040
Professional Enrollment ID
I20050908000130
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

  • 122, East Emerson Road, Lexington, Middlesex County, Massachusetts, 02420, United States

    LEXINGTON, MA 024202100

    Phone: (781) 863-8190

    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 02420)

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Provider's Procedures

Unknown Individual performs procedures in Diagnostic Radiology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DIAGNOSTIC RADIOLOGYMA71010X-ray of chest, 1 view, front400317
DIAGNOSTIC RADIOLOGYMA73110X-ray of wrist, minimum of 3 views3735
DIAGNOSTIC RADIOLOGYMA73630X-ray of foot, minimum of 3 views4038
DIAGNOSTIC RADIOLOGYMA74177CT scan of abdomen and pelvis with contrast2727

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: 6406270040View full group profile
NameSpecialtyState
Interventional Radiology, Diagnostic RadiologyMA
Diagnostic RadiologyMA
-MA
Interventional Radiology, Diagnostic RadiologyMA
Interventional Radiology, Diagnostic RadiologyMA
Nuclear Medicine, Diagnostic RadiologyMA
Diagnostic RadiologyMA
Diagnostic RadiologyNH
Diagnostic RadiologyMA
-MA

Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1205883998 for Unknown Individual.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Diagnostic Radiology Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Lexington, Massachusetts?
If you are local to Lexington, Massachusetts, Unknown Individual may be relevant to your search.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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