Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1215020680

Unknown Individual is a healthcare provider. based in Milford, Massachusetts. specializing in Certified Registered Nurse Anesthetist. They hold a License No. 141612 (MA). The NPI Number for Unknown Individual is 1215020680

Main info

Organization
Inactive
46 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1215020680
Phone
(508) 473-1190
Address
14 PROSPECT ST
Deactivation Date
1 November 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5089029705
Graduation Year
1980 (46 years ago)
PAC ID
1254355563
Group Practice PAC ID
4981669959
Professional Enrollment ID
I20060125000238
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

  • Milford Regional Medical Center, 14, Prospect Street, Milford, Worcester County, Massachusetts, 01757, United States

    MILFORD, MA 017573003

    Phone: (508) 473-1190

    Type: Location

  • 18, Cooper Parkway, Pittsfield, Berkshire County, Massachusetts, 01201, United States

    PITTSFIELD, MA 012017338

    Phone: (413) 442-3032

    Type: Mailing

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
00811Anesthesia for other procedure on large bowel using an endoscope1717$0
00812Anesthesia for exam of colon using an endoscope1212$0
View full utilization report →

Insurance plans in this area (ZIP 01757)

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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: 4981669959View full group profile

Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1215020680?
NPI 1215020680 belongs to Unknown Individual; compare other details if you need extra assurance.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Certified Registered Nurse Anesthetist in the directory — Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Milford?
Unknown Individual currently maps to Milford, Massachusetts in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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