Unknown Individual – Internal Medicine Physician, NPI 1821083767

Unknown Individual is a healthcare provider. based in Waltham, Massachusetts. specializing in Internal Medicine Physician. They hold a License No. 81398 (MA). The NPI Number for Unknown Individual is 1821083767

Main info

Organization
Inactive
33 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1821083767
Phone
(781) 547-6030
Address
9 HOPE AVE
Deactivation Date
9 May 2022

Doctor Profile

Medical School Name
BOSTON UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
7817924136
Graduation Year
1993 (33 years ago)
PAC ID
8628098530
Group Practice PAC ID
7113029257
Professional Enrollment ID
I20051206000687
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

  • Hope Ave @ Sterling Medical Center, 9, Hope Avenue, Riverview, Waltham, Middlesex County, Massachusetts, 02453, United States

    SUITE 152

    WALTHAM, MA 02453

    Phone: (781) 547-6030

    Fax: (781) 547-6036

    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 02453)

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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: 7113029257View full group profile
NameSpecialtyState
Pain Management, AnesthesiologyMA
-MA
Physician AssistantMA
General SurgeryNJ
U R O L O G YMA
Internal MedicineME
Physician AssistantIN
O B S T E T R I C S/ G Y N E C O L O G YMA
Physician AssistantMA
Emergency MedicineMA

Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1821083767 when you need to reference Unknown Individual in forms, claims, or directories.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Waltham, Massachusetts for Unknown Individual; expand the address list for detail.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1821083767. Always confirm identity and privileges with the practice and licensing boards.

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