Unknown Individual – Clinical Social Worker, NPI 1083058838

Unknown Individual is a healthcare provider. based in Matawan, New Jersey. specializing in Clinical Social Worker. They hold a License No. 44SC05536300 (NJ). The NPI Number for Unknown Individual is 1083058838

Main info

Organization
Inactive
28 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1083058838
Phone
(732) 858-4404
Address
253 MAIN ST
Deactivation Date
28 September 2022

Doctor Profile

Medical School Name
CALIFORNIA SCHOOL OF PODIATRIC MEDICINE
Secondary Phone
9732640023
Graduation Year
1998 (28 years ago)
PAC ID
8921232620
Group Practice PAC ID
0547335366
Professional Enrollment ID
I20131014000028
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 253 MAIN ST

    SUITE 269

    MATAWAN, NJ 077473222

    Phone: (732) 858-4404

    Type: Mailing

  • 46 BAYARD ST

    SUITE 302

    NEW BRUNSWICK, NJ 089012152

    Phone: (732) 858-4404

    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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 07747)

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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: 0547335366View full group profile

Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1083058838.
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's primary classification?
Clinical Social Worker is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Matawan, New Jersey 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.

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