Unknown Individual – Psychiatry Physician, NPI 1922094762

Unknown Individual is a healthcare provider. based in Ludlow, Massachusetts. specializing in Psychiatry Physician. They hold a License No. 50517 (MA). The NPI Number for Unknown Individual is 1922094762

Main info

Organization
Inactive
46 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1922094762
Phone
(413) 583-6750
Address
77 WINSOR ST
Deactivation Date
11 October 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4135836750
Graduation Year
1980 (46 years ago)
PAC ID
9638126634
Group Practice PAC ID
7517021967
Professional Enrollment ID
I20050401000371
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

  • 77, Winsor Street, Ludlow, Hampden County, Massachusetts, 01151, United States

    STE 101

    LUDLOW, MA 01056

    Phone: (413) 583-6750

    Fax: (413) 589-7001

    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 01056)

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Provider's Procedures

Unknown Individual performs procedures in Psychiatry Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PSYCHIATRYMA90792Psychiatric diagnostic evaluation with medical services4545

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: 7517021967View full group profile

Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1922094762.
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 type of care does Unknown Individual provide?
Unknown Individual's profile centers on Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Ludlow, Massachusetts?
If you are local to Ludlow, Massachusetts, Unknown Individual may be relevant to your search.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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