Unknown Individual – Psychiatry Physician, NPI 1902825300

Unknown Individual is a healthcare provider. based in Boston, Massachusetts. specializing in Psychiatry Physician. They hold a License No. 30673 (MA). The NPI Number for Unknown Individual is 1902825300

Main info

Organization
Inactive
63 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1902825300
Phone
Not provided
Address
PO BOX 415348
Deactivation Date
23 October 2024

Doctor Profile

Medical School Name
NORTHWESTERN UNIVERSITY FEINBERG MEDICAL SCHOOL
Secondary Phone
5087535425
Graduation Year
1963 (63 years ago)
PAC ID
6103842216
Group Practice PAC ID
7911916093
Professional Enrollment ID
I20051018000999
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

  • PO Box 846028, Albany Street, Church Green, Financial District, Boston, Suffolk County, Massachusetts, 02284-6028, United States

    BOSTON, MA 022415348

    Phone:

    Type: Mailing

  • UMASS Memorial Medical Center University Campus Hospital, 55, Lake Avenue North, Worcester, Worcester County, Massachusetts, 01653, United States

    DEPARTMENT OF PSYCHIATRY

    WORCESTER, MA 016550002

    Phone: (508) 334-3240

    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.

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

Insurance plans in this area (ZIP 02241)

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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: 7911916093View full group profile
NameSpecialtyState
MS. KATHARINE PERKINS (MSW)
-MA
Unknown Individual
-MA
MRS. ESTELLE JUDITH UCKERMAN (APRN, BC)
-MA
JOHANNA DARYL SAGARIN (PHD)
-MA

Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1902825300.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Boston, Massachusetts as a primary anchor for Unknown Individual unless the record lists multiple sites.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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