Unknown Individual – Internal Medicine Physician, NPI 1780889386

Internal Medicine Physician

Unknown Individual is a healthcare provider. based in West bridgewater, Massachusetts. specializing in Internal Medicine Physician. They hold a License No. 239597 (MA). The NPI Number for Unknown Individual is 1780889386

Main info

Organization

Inactive

19 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1780889386

Phone

(508) 238-8646

Address

35 UNITED DR STE 102

Deactivation Date

18 December 2025

Doctor Profile

Medical School Name

UNIVERSITY OF VIRGINIA SCHOOL OF MEDICINE

Secondary Phone

9789980010

Graduation Year

2007 (19 years ago)

PAC ID

6800927914

Group Practice PAC ID

1153653027

Professional Enrollment ID

I20100706000025

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

35 UNITED DR STE 102
WEST BRIDGEWATER, MA 023791056
Phone: (508) 238-8646
Type: Mailing
311, Highland Avenue, Salem, Essex County, Massachusetts, 01970, United States
SALEM, MA 019702733
Phone: (978) 998-0010
Type: Location
84 HIGHLAND AVE STE 311
SALEM, MA 019702733
Phone: (781) 710-1420
Fax: (978) 224-2990
Type: Mailing

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

HCPCS	Description	Services	Beneficiaries	Medicare allowed
99215	Established patient office or other outpatient visit, 40-54 minutes	375	141	$0
99205	New patient office or other outpatient visit, 60-74 minutes	62	62	$0
99214	Established patient office or other outpatient visit, 30-39 minutes	15	11	$0

View full utilization report →

Insurance plans in this area (ZIP 02379)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 1153653027View full group profile

Name	Specialty	State
MS. MEGHAN MARGARET CLEMENTS (N.P.)	Nurse Practitioner	MA
KEIRSTEN ASSAD (C.N.P.)	Nurse Practitioner	NH
RICHARD ARNOLD (FNP, BC)	Nurse Practitioner	MA
MRS. LAUREN REPOSA (CNP, FNP-C)	Nurse Practitioner	MA

Reviews

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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 1780889386 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 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 West Bridgewater, Massachusetts may find Unknown Individual in results; validate coverage separately.

Is the information about Unknown Individual up to date?

Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."