Unknown Individual – Endocrinology, Diabetes & Metabolism Physician, NPI 1093809238

Unknown Individual is a healthcare provider. based in Marlton, New Jersey. specializing in Endocrinology, Diabetes & Metabolism Physician. They hold a License No. MB04814600 (NJ). The NPI Number for Unknown Individual is 1093809238

Main info

Organization
Inactive
42 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1093809238
Phone
(856) 810-7337
Address
100 BRICK RD
Deactivation Date
15 November 2024

Doctor Profile

Medical School Name
PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
-
Graduation Year
1984 (42 years ago)
PAC ID
9830159276
Professional Enrollment ID
I20041012000216
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

  • 100, Brick Road, The Promenade, Evesham Township, Burlington County, New Jersey, 08053-2146, United States

    SUITE 108

    MARLTON, NJ 080532146

    Phone: (856) 810-7337

    Fax: (856) 810-7917

    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 3 Open Payments records for all available years, with a total value of $55.

Total Amount is formed as General ($55) + Research ($0) + Ownership ($0) = $55.

Last reported payment date: 2023-05-08 • Largest payer in this snapshot: Ascensia Diabetes Care Us Inc. ($28).

Total Amount

$55

General + Research + Ownership

Payments

3

Total payment records

General Amount

$55

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-05-08

Latest reported date

Top Companies

Largest payers in this snapshot

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes15499$0
99204New patient office or other outpatient visit, 45-59 minutes2222$0
99213Established patient office or other outpatient visit, 20-29 minutes1512$0
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Insurance plans in this area (ZIP 08053)

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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 1093809238.
Is Unknown Individual excluded from programs when inactive?
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?
Endocrinology, Diabetes & Metabolism Physician is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Marlton, New Jersey in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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