Unknown Individual – Podiatrist, NPI 1972517605

Podiatrist

Unknown Individual is a healthcare provider. based in Wellesley, Massachusetts. specializing in Podiatrist. They hold a License No. 0306 (NH). The NPI Number for Unknown Individual is 1972517605

Main info

Organization

Inactive

26 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1972517605

Phone

(617) 964-6681

Address

888 WORCESTER ST

Deactivation Date

14 December 2020

Doctor Profile

Medical School Name

OTHER

Secondary Phone

6179646681

Graduation Year

2000 (26 years ago)

PAC ID

9638070394

Group Practice PAC ID

3375446958

Professional Enrollment ID

I20060410000362

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience23

Completeness75

Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

Dennis Sullivan & Associates, 888, Worcester Street, Overbrook, Wellesley, Norfolk County, Massachusetts, 02482, United States
SUITE 130
WELLESLEY, MA 024823744
Phone: (617) 964-6681
Fax: (339) 686-2561
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 02482)

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Provider's Procedures

Unknown Individual performs procedures in Podiatrist. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
PODIATRY	MA	11720	Removal of tissue from 1 to 5 finger or toe nails	2038	907

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: 3375446958View full group profile

Name	Specialty	State
DR. ANTHONY MICHAEL RABAIOTTI (DPM)	P O D I A T R Y	CA
DR. MICHAEL DEAN O'BORSKY (D.P.M.)	P O D I A T R Y	MN
MICHAEL D A CICERO (D.P.M.)	P O D I A T R Y	MA
DR. SHADI ADIB ABBOUD (DPM)	P O D I A T R Y	MA
SHERRY HICKS STENEHJEM (DPM)	P O D I A T R Y	MA
DR. KAREN M RINEHART (DPM)	P O D I A T R Y	ND
DR. KARIMAH Z SHABAZZ (DPM)	P O D I A T R Y	MN
DR. KELLEE JANEEN CAMPBELL (DPM)	P O D I A T R Y	FL
DR. AMY KOTOUCH (D.P.M.)	-	MA
DR. ANDREW OLSON (DPM)	P O D I A T R Y	NY

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 1972517605.

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 Podiatrist. Clinical services aligned with this taxonomy classification.

Which community is linked to Unknown Individual?

Unknown Individual shows a connection to Wellesley, Massachusetts in registry-derived data.

Why is information missing for Unknown Individual?

Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.