Unknown Individual – Anatomic Pathology Physician, NPI 1124097001

Unknown Individual is a healthcare provider. based in Fair lawn, New Jersey. specializing in Anatomic Pathology Physician. They hold a License No. MA03418 (NJ). The NPI Number for Unknown Individual is 1124097001

Main info

Organization
Inactive
61 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1124097001
Phone
(201) 797-7129
Address
41-04 GOLDBLATT TER
Deactivation Date
30 October 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1965 (61 years ago)
PAC ID
8224116470
Professional Enrollment ID
I20080429000281
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

  • Goldblatt Terrace, Fair Lawn, Bergen County, New Jersey, 07410, United States

    FAIR LAWN, NJ 074105911

    Phone: (201) 797-7129

    Fax: (201) 703-6892

    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 1 Open Payments records for all available years, with a total value of $14.

Total Amount is formed as General ($14) + Research ($0) + Ownership ($0) = $14.

Last reported payment date: 2023-04-25 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($14).

Total Amount

$14

General + Research + Ownership

Payments

1

Total payment records

General Amount

$14

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-04-25

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Merck Sharp & Dohme LLC$14
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
99213Established patient office or other outpatient visit, 20-29 minutes7843$0
36415Insertion of needle into vein for collection of blood sample2620$0
View full utilization report →

Insurance plans in this area (ZIP 07410)

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Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1124097001 for Unknown Individual.
What does inactive NPI status mean for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
What does the directory say Unknown Individual does?
Insurance directories may phrase it differently, but here Unknown Individual maps to Anatomic Pathology Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Fair Lawn, New Jersey?
If you are local to Fair Lawn, New Jersey, Unknown Individual may be relevant to your search.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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