Unknown Individual – Adult Health Nurse Practitioner, NPI 1396244042

Unknown Individual is a healthcare provider. based in West springfield, Massachusetts. specializing in Adult Health Nurse Practitioner. They hold a License No. RN2280352 (MA). The NPI Number for Unknown Individual is 1396244042

Main info

Organization
Inactive
9 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1396244042
Phone
(413) 785-1153
Address
271 PARK STREET
Deactivation Date
18 January 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4137851153
Graduation Year
2017 (9 years ago)
PAC ID
7810259991
Group Practice PAC ID
5991609174
Professional Enrollment ID
I20180330000233
Data current as of
20 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

  • 271, Park Street, Springfield, Penobscot County, Maine, 04487, United States

    WEST SPRINGFIELD, MA 01089

    Phone: (413) 785-1153

    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 $23.

Total Amount is formed as General ($23) + Research ($0) + Ownership ($0) = $23.

Last reported payment date: 2023-02-22 • Largest payer in this snapshot: ABBVIE INC. ($23).

Total Amount

$23

General + Research + Ownership

Payments

1

Total payment records

General Amount

$23

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-02-22

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$23
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.

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

Insurance plans in this area (ZIP 01089)

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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: 5991609174View full group profile
NameSpecialtyState
Nurse PractitionerCT
Physician AssistantMA
Physician AssistantMA
Physical Therapist In Private PracticeMA
Physical Medicine And RehabilitationNY
Physical Therapist In Private PracticeMA
Physical Medicine And RehabilitationMA
Physical Therapist In Private PracticeMA
Physician AssistantMA
Physical Medicine And RehabilitationMA

Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1396244042.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual's primary classification?
Adult Health Nurse Practitioner is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to West Springfield, Massachusetts in the data we show; additional addresses may exist on the full record.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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