Unknown Individual – Family Medicine Physician, NPI 1811007347

Unknown Individual is a healthcare provider. based in Brewster, Massachusetts. specializing in Family Medicine Physician. They hold a License No. 59680 (MA). The NPI Number for Unknown Individual is 1811007347

Main info

Organization
Inactive
44 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1811007347
Phone
(508) 255-7200
Address
20 GRANITE STATE CT
Deactivation Date
22 February 2021

Doctor Profile

Medical School Name
UNIVERSITY OF NEW ENGLAND, COLLEGE OF OSTEO MEDICINE
Secondary Phone
5082557200
Graduation Year
1982 (44 years ago)
PAC ID
6800969510
Group Practice PAC ID
4688616733
Professional Enrollment ID
I20080714000355
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

  • Granite State Court, Brewster, Barnstable County, Massachusetts, 02653, United States

    BREWSTER, MA 026312127

    Phone: (508) 255-7200

    Fax: (508) 247-9801

    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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02631)

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Provider's Procedures

Unknown Individual performs procedures in Family Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINEMA20610Aspiration and/or injection of large joint or joint capsule1715

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: 4688616733View full group profile
NameSpecialtyState
Family PracticeNJ
Family PracticeMA

Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1811007347.
Is Unknown Individual still active if the NPI shows inactive?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Brewster?
Unknown Individual currently maps to Brewster, Massachusetts in this extract.
Can I trust this NPI listing for Unknown Individual?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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