Unknown Individual – Medical Physician Assistant, NPI 1861838997

Unknown Individual is a healthcare provider. based in Southbridge, Massachusetts. specializing in Medical Physician Assistant. They hold a License No. PA4572 (MA). The NPI Number for Unknown Individual is 1861838997

Main info

Organization
Inactive
14 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1861838997
Phone
(508) 909-7799
Address
PO BOX 40
Deactivation Date
29 May 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5084991760
Graduation Year
2012 (14 years ago)
PAC ID
6800011214
Group Practice PAC ID
2567543689
Professional Enrollment ID
I20140626002511
Data current as of
20 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

  • PO BOX 40

    SOUTHBRIDGE, MA 015500040

    Phone: (508) 909-7799

    Type: Mailing

  • 10 N MAIN ST

    CHARLTON, MA 01507

    Phone: (508) 248-1770

    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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes226212$0
99203New patient office or other outpatient visit, 30-44 minutes4343$0
U00022019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc2929$0
81003Automated urinalysis test2423$0
71046X-ray of chest, 2 views2121$0
View full utilization report →

Insurance plans in this area (ZIP 01550)

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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: 2567543689View full group profile

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 1861838997.
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 kind of doctor is Unknown Individual?
Unknown Individual is associated with Medical Physician Assistant in the directory — Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Southbridge, Massachusetts as the reference point for Unknown Individual, then confirm.
Does Unknown Individual accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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