Unknown Individual – Nurse Practitioner, NPI 1861513798

Unknown Individual is a healthcare provider. based in Everett, Massachusetts. specializing in Nurse Practitioner. They hold a License No. 167796 (MA). The NPI Number for Unknown Individual is 1861513798

Main info

Organization
Inactive
39 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1861513798
Phone
(617) 394-7703
Address
103 GARLAND ST
Deactivation Date
3 May 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6176651000
Graduation Year
1987 (39 years ago)
PAC ID
8527083153
Group Practice PAC ID
8921910894
Professional Enrollment ID
I20051012000489
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

Provider Addresses for Unknown Individual

  • 103 GARLAND ST

    EVERETT, MA 021495066

    Phone: (617) 394-7703

    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 02149)

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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: 8921910894View full group profile
NameSpecialtyState
Family PracticeMA
-MA
-NH
Rheumatology, Internal MedicineMA
-MA
Emergency MedicineMA
Family PracticeMA
O B S T E T R I C S/ G Y N E C O L O G YPA
Emergency MedicineMA
Physician AssistantMA

Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1861513798.
Does inactive mean outdated data for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Everett, Massachusetts in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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