Unknown Individual – Primary Podiatric Medicine Podiatrist, NPI 1639122005

Unknown Individual is a healthcare provider. based in Greenfield, Massachusetts. specializing in Primary Podiatric Medicine Podiatrist. They hold a License No. 1879 (MA). The NPI Number for Unknown Individual is 1639122005

Main info

Organization
Inactive
39 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1639122005
Phone
(413) 774-4450
Address
33 RIDDELL ST
Deactivation Date
6 December 2023

Doctor Profile

Medical School Name
TEMPLE UNIVERSITY SCHOOL OF PODIATRIC MEDICINE
Secondary Phone
4139675877
Graduation Year
1987 (39 years ago)
PAC ID
8820006794
Professional Enrollment ID
I20060404000366
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 33, Riddell Street, Greenfield, Franklin County, Massachusetts, 01301, United States

    GREENFIELD, MA 013012025

    Phone: (413) 774-4450

    Fax: (413) 773-9484

    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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes421179$0
99202New patient office or other outpatient visit, 15-29 minutes3838$0
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Insurance plans in this area (ZIP 01301)

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Provider's Procedures

Unknown Individual performs procedures in Primary Podiatric Medicine Podiatrist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PODIATRYMA11042Removal of skin and tissue first 20 sq cm or less2411

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1639122005 in the public NPI dataset.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Primary Podiatric Medicine Podiatrist. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Greenfield, Massachusetts in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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