Unknown Individual – Psychiatry Physician, NPI 1578569356

Unknown Individual is a healthcare provider. based in Newton, Massachusetts. specializing in Psychiatry Physician. They hold a License No. 26016 (MA). The NPI Number for Unknown Individual is 1578569356

Main info

Organization
Inactive
68 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1578569356
Phone
Not provided
Address
21 WHITTLESEY RD
Deactivation Date
25 September 2025

Doctor Profile

Medical School Name
HARVARD MEDICAL SCHOOL
Secondary Phone
6173320032
Graduation Year
1958 (68 years ago)
PAC ID
8921047085
Professional Enrollment ID
I20050427001397
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

  • 21, Whittlesey Road, Oak Hill, Newton, Middlesex County, Massachusetts, 02459, United States

    NEWTON, MA 024592621

    Phone:

    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 02459)

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Provider's Procedures

Unknown Individual performs procedures in Psychiatry Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
GERIATRIC PSYCHIATRYMA90833Psychotherapy, 30 minutes with patient and/or family member4811

Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?
The NPI 1578569356 uniquely identifies Unknown Individual in U.S. healthcare data.
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.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Psychiatry Physician. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Newton, Massachusetts. Check all listed addresses for suites or satellite offices.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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