Unknown Individual – Diagnostic Radiology Physician, NPI 1518965623

Unknown Individual is a healthcare provider. based in Brookline, Massachusetts. specializing in Diagnostic Radiology Physician. They hold a License No. 42551 (MA). The NPI Number for Unknown Individual is 1518965623

Main info

Organization
Inactive
50 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1518965623
Phone
(617) 739-0245
Address
1 BROOKLINE PL
Deactivation Date
27 October 2022

Doctor Profile

Medical School Name
HARVARD MEDICAL SCHOOL
Secondary Phone
6177390245
Graduation Year
1976 (50 years ago)
PAC ID
7517994247
Group Practice PAC ID
1951485507
Professional Enrollment ID
I20050725000298
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

  • 1, Brookline Place, Brookline, Norfolk County, Massachusetts, 02130-4803, United States

    SUITE 506

    BROOKLINE, MA 024457224

    Phone: (617) 739-0245

    Fax: (617) 738-6703

    Type: Location

  • 340, Main Street, Leominster, Worcester County, Massachusetts, 01453, United States

    STE 670

    WORCESTER, MA 016081604

    Phone: (508) 754-3566

    Fax: (508) 438-6368

    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.

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

Insurance plans in this area (ZIP 02445)

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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 RADIOLOGYMA76830Ultrasound pelvis through vagina1616

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: 1951485507View full group profile
NameSpecialtyState
O B S T E T R I C S/ G Y N E C O L O G YMA
O B S T E T R I C S/ G Y N E C O L O G YMA
O B S T E T R I C S/ G Y N E C O L O G YMA
O B S T E T R I C S/ G Y N E C O L O G YMA

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 1518965623.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's primary classification?
Diagnostic Radiology Physician is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Brookline, Massachusetts; more addresses can appear in NPPES.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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