Unknown Individual – Psychiatry Physician, NPI 1760460315

Unknown Individual is a healthcare provider. based in Milton, Massachusetts. specializing in Psychiatry Physician. They hold a License No. 73666 (MA). The NPI Number for Unknown Individual is 1760460315

Main info

Organization
Inactive
37 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1760460315
Phone
(617) 361-1169
Address
39 GREEN ST
Deactivation Date
10 April 2024

Doctor Profile

Medical School Name
BOSTON UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
6173611169
Graduation Year
1989 (37 years ago)
PAC ID
7012963127
Professional Enrollment ID
I20050322000903
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

  • 39, Green Street, Milton, Norfolk County, Massachusetts, 02187, United States

    MILTON, MA 021862318

    Phone: (617) 361-1169

    Fax: (617) 361-5176

    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 2 Open Payments records for all available years, with a total value of $0.

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

Last reported payment date: • Largest payer in this snapshot: CLOZEX MEDICAL INC ($0).

Total Amount

$0

General + Research + Ownership

Payments

2

Total payment records

General Amount

$0

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

2

Ownership records

Last Payment Date

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
CLOZEX MEDICAL INC$0
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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes25023$0
90836Psychotherapy with evaluation and management visit, 45 minutes23121$0
View full utilization report →

Insurance plans in this area (ZIP 02186)

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Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1760460315?
NPI 1760460315 belongs to Unknown Individual; compare other details if you need extra assurance.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Milton?
Public fields place Unknown Individual around Milton, Massachusetts. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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