Unknown Individual – Anatomic Pathology & Clinical Pathology Physician, NPI 1679562110

Unknown Individual is a healthcare provider. based in Boston, Massachusetts. specializing in Anatomic Pathology & Clinical Pathology Physician. They hold a License No. 48975 (MA). The NPI Number for Unknown Individual is 1679562110

Main info

Organization
Inactive
50 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1679562110
Phone
(781) 278-6279
Address
461 COMMONWEALTH AVE
Deactivation Date
17 May 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7812786279
Graduation Year
1976 (50 years ago)
PAC ID
4284680216
Group Practice PAC ID
0244273662
Professional Enrollment ID
I20050323000608
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

  • 461, Commonwealth Avenue, Fenway, Boston, Suffolk County, Massachusetts, 02215, United States

    BOSTON, MA 022152223

    Phone: (781) 278-6279

    Fax: (781) 551-0619

    Type: Mailing

  • Norwood Hospital, 800, Washington Street, Winslows, Norwood, Norfolk County, Massachusetts, 02062, United States

    ATTN: PATHOLOGY DEPT

    NORWOOD, MA 02062

    Phone: (781) 769-4000

    Fax: (781) 551-0619

    Type: Location

  • St. Elizabeth's Medical Center

    736 Cambridge Street

    Brighton, MA 021352907

    Phone: (617) 789-2740

    Type: Location

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.

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Medicare Enrollment & Revalidation

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Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

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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 02215)

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Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1679562110.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Anatomic Pathology & Clinical Pathology Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Boston, Massachusetts. Check all listed addresses for suites or satellite offices.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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