Unknown Individual – Internal Medicine Physician, NPI 1114999323

Unknown Individual is a healthcare provider. based in Metuchen, New Jersey. specializing in Internal Medicine Physician. They hold a License No. 25MA03932000 (NJ). The NPI Number for Unknown Individual is 1114999323

Main info

Organization
Inactive
50 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1114999323
Phone
(732) 494-3177
Address
280 MAIN ST
Deactivation Date
10 May 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7322879555
Graduation Year
1976 (50 years ago)
PAC ID
3173577210
Professional Enrollment ID
I20050310000825
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 280, Main Street, Jefferson Park, Metuchen, Middlesex County, New Jersey, 08840, United States

    METUCHEN, NJ 08840

    Phone: (732) 494-3177

    Fax: (732) 494-0827

    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 08840)

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Provider's Procedures

Unknown Individual performs procedures in Internal Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
INTERNAL MEDICINENJ93010Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report562399
INTERNAL MEDICINENJ93280Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report4227

Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1114999323 for Unknown Individual, then check state licensing separately.
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 healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Metuchen, New Jersey in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.