Unknown Individual – Internal Medicine Physician, NPI 1760464606

Unknown Individual is a healthcare provider. based in Somerville, Massachusetts. specializing in Internal Medicine Physician. They hold a License No. 78603 (MA). The NPI Number for Unknown Individual is 1760464606

Main info

Organization
Inactive
35 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1760464606
Phone
(617) 625-9992
Address
PO BOX 201
Deactivation Date
25 January 2023

Doctor Profile

Medical School Name
BOSTON UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
1991 (35 years ago)
PAC ID
9234032335
Professional Enrollment ID
I20050830000743
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

  • PO BOX 201

    SOMERVILLE, MA 021430004

    Phone: (617) 625-9992

    Fax: (617) 666-0662

    Type: Mailing

  • 33;35A;35B;37, Bow Street, Union Square, Somerville, Middlesex County, Massachusetts, 02143, United States

    SOMERVILLE, MA 021432937

    Phone: (617) 625-9992

    Fax: (617) 666-0662

    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.

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 02143)

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Provider's Procedures

Unknown Individual performs procedures in Internal Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
INTERNAL MEDICINEMA81002Urinalysis, manual test274145
INTERNAL MEDICINEMA85610Blood test, clotting time23715

Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1760464606.
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 taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Internal Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Somerville, Massachusetts may find Unknown Individual in results; validate coverage separately.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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