Unknown Individual – Family Medicine Physician, NPI 1982775185

Unknown Individual is a healthcare provider. based in Hyde park, Massachusetts. specializing in Family Medicine Physician. They hold a License No. 28568 (MA). The NPI Number for Unknown Individual is 1982775185

Main info

Organization
Inactive
62 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1982775185
Phone
(617) 364-2420
Address
1234 HYDE PARK AVE
Deactivation Date
6 February 2025

Doctor Profile

Medical School Name
PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
6173642420
Graduation Year
1964 (62 years ago)
PAC ID
0143260794
Group Practice PAC ID
9234205394
Professional Enrollment ID
I20050503001322
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

  • 1234, Hyde Park Avenue, Hyde Park, Boston, Suffolk County, Massachusetts, 02136, United States

    HYDE PARK, MA 021362819

    Phone: (617) 364-2420

    Fax: (617) 364-1845

    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)

CMS reports 103 Open Payments records for all available years, with a total value of $2,228.

Total Amount is formed as General ($2,228) + Research ($0) + Ownership ($0) = $2,228.

Last reported payment date: 2024-11-19 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($395).

Total Amount

$2,228

General + Research + Ownership

Payments

103

Total payment records

General Amount

$2,228

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-19

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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 02136)

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Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1982775185; it appears in the national provider directory.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
What kind of provider is Unknown Individual?
The page reflects Family Medicine Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Hyde Park, Massachusetts for Unknown Individual; expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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