Unknown Individual – Sports Medicine (Orthopaedic Surgery) Physician, NPI 1306848643

Unknown Individual is a healthcare provider. based in Boston, Massachusetts. specializing in Sports Medicine (Orthopaedic Surgery) Physician. They hold a License No. 228936 (MA). The NPI Number for Unknown Individual is 1306848643

Main info

Organization
Inactive
26 Years Of Experience
Name
Unknown Individual
NPI
1306848643
Phone
(617) 636-5148
Address
800 WASHINGTON ST
Deactivation Date
16 October 2024

Doctor Profile

Medical School Name
COLUMBIA UNIVERSITY COLLEGE OF PHYSICIANS AND SURGEONS
Secondary Phone
6176365162
Graduation Year
2000 (26 years ago)
PAC ID
8820026545
Group Practice PAC ID
7618295437
Professional Enrollment ID
I20070115000047
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Tufts Medical Center, 800, Washington Street, Chinatown, Financial District, Boston, Suffolk County, Massachusetts, 02111, United States

    BOX 306

    BOSTON, MA 021111552

    Phone: (617) 636-5148

    Fax: (617) 636-5178

    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)

CMS reports 1 Open Payments records for all available years, with a total value of $24.

Total Amount is formed as General ($24) + Research ($0) + Ownership ($0) = $24.

Last reported payment date: 2023-04-11 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($24).

Total Amount

$24

General + Research + Ownership

Payments

1

Total payment records

General Amount

$24

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-04-11

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Merck Sharp & Dohme LLC$24
View all Open Payments →|Open Payments Risk Radar →

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
99213Established patient office or other outpatient visit, 20-29 minutes338169$0
J0702Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg26075$0
20610Aspiration and/or injection of fluid from large joint11175$0
99203New patient office or other outpatient visit, 30-44 minutes4141$0
99214Established patient office or other outpatient visit, 30-39 minutes2726$0
View full utilization report →

Insurance plans in this area (ZIP 02111)

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Provider's Procedures

Unknown Individual performs procedures in Sports Medicine (Orthopaedic Surgery) Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
ORTHOPEDIC SURGERYMA20610Aspiration and/or injection of large joint or joint capsule14892

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: 7618295437View full group profile
NameSpecialtyState
Hand SurgeryMA
Physician AssistantMA
P O D I A T R YMA
Orthopedic SurgeryTX
Physician AssistantNY
Physician AssistantMA
Physician AssistantMA
Orthopedic SurgeryPA
Orthopedic SurgeryMA
Orthopedic Surgery, Sports MedicineFL

Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1306848643?
NPI 1306848643 belongs to Unknown Individual; compare other details if you need extra assurance.
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 area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Sports Medicine (Orthopaedic Surgery) Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Boston?
Public fields place Unknown Individual around Boston, Massachusetts. Always confirm the exact site before visiting.
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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