Unknown Individual – Emergency Medicine Physician, NPI 1902987720

Emergency Medicine Physician

Unknown Individual is a healthcare provider. based in Woburn, Massachusetts. specializing in Emergency Medicine Physician. They hold a License No. 157638 (MA). The NPI Number for Unknown Individual is 1902987720

Main info

Organization

Inactive

32 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1902987720

Phone

(781) 937-4522

Address

12 GILL ST

Deactivation Date

23 October 2024

Doctor Profile

Medical School Name

UNIVERSITY OF NEW ENGLAND, COLLEGE OF OSTEO MEDICINE

Secondary Phone

9784631000

Graduation Year

1994 (32 years ago)

PAC ID

9931002334

Group Practice PAC ID

6608772124

Professional Enrollment ID

I20040202000373

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

12, Gill Street, Mishawum, Woburn, Middlesex County, Massachusetts, 01801, United States
STE 3000
WOBURN, MA 018011728
Phone: (781) 937-4522
Type: Mailing
Anna Jaques Hospital, 25, Highland Avenue, Newburyport, Essex County, Massachusetts, 01950, United States
ANNA JAQUES HOSPITAL-ER DEPT
NEWBURYPORT, MA 019503867
Phone: (978) 463-1050
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

HCPCS	Description	Services	Beneficiaries	Medicare allowed
99285	Emergency department visit with high level of medical decision making	37	37	$0
93010	Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	20	20	$0
99284	Emergency department visit with moderate level of medical decision making	12	12	$0

View full utilization report →

Insurance plans in this area (ZIP 01801)

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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: 6608772124View full group profile

Name	Specialty	State
JOHN MCLAULIN (M.D.)	Emergency Medicine	MA
DORON E. KORINOW (MD)	Emergency Medicine	MA
KIERSTEN L GURLEY (M.D.)	Emergency Medicine	NH
SUSAN K BORERI (MD)	Emergency Medicine	MA
JAMES L. II MORSE (MD)	Emergency Medicine	MA
MAUREEN M. CULLEN (NP)	-	MA
MATTHEW COTE (M.D.)	Emergency Medicine	MA
DR. BENJAMIN HOUGH EVENCHIK (M.D.)	Emergency Medicine	MA
BENJAMIN CHIN (DO)	Emergency Medicine	MA
OWEN BEAMS (MD)	Emergency Medicine	NH

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 1902987720.

Why is Unknown Individual marked inactive in the NPI directory?

The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.

What is Unknown Individual best known for clinically?

Directory data describes Unknown Individual with Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.

Where is Unknown Individual based?

Unknown Individual is tied to Woburn, Massachusetts in the data we show; additional addresses may exist on the full record.

Is specialty guaranteed by NPI alone?

Taxonomy selections describe intent; scope of practice still follows state law.