Unknown Individual – Psychiatry Physician, NPI 1053487439

Unknown Individual is a healthcare provider. based in Westampton, New Jersey. specializing in Psychiatry Physician. They hold a License No. 25MA07943900 (NJ). The NPI Number for Unknown Individual is 1053487439

Main info

Organization
Inactive
25 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1053487439
Phone
(609) 267-7000
Address
650 RANCOCAS RD
Deactivation Date
11 December 2025

Doctor Profile

Medical School Name
RUTGERS R W JOHNSON MEDICAL SCHOOL (CAM/NEW BRUNS/PISC)
Secondary Phone
6092677000
Graduation Year
2001 (25 years ago)
PAC ID
7719911031
Group Practice PAC ID
7911992912
Professional Enrollment ID
I20050926000735
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

  • 650, Beverly-Rancocas Road, Twin Hill Park, Willingboro Township, Burlington County, New Jersey, 08046, United States

    WESTAMPTON, NJ 080605613

    Phone: (609) 267-7000

    Fax: (609) 518-2150

    Type: Location

  • Spruce Street, Fitler Square, Center City, Philadelphia, Philadelphia County, Pennsylvania, 19103, United States

    PHILADELPHIA, PA 191076175

    Phone: (917) 292-4934

    Type: Mailing

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 08060)

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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
PSYCHIATRYNJ93010Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report4338

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: 7911992912View full group profile
NameSpecialtyState
Nurse PractitionerNJ
Family PracticeVA
Internal MedicineFL
P S Y C H I A T R YNJ
Nurse PractitionerNJ
P S Y C H I A T R YPA
Physician AssistantNJ
-NY
-NJ
P S Y C H I A T R YNJ

Reviews

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Frequently asked questions

What is the standard ID for Unknown Individual in the U.S.?
In the U.S., Unknown Individual is identified by NPI 1053487439.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Psychiatry Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Westampton, New Jersey in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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