Unknown Individual – Surgery Physician, NPI 1164571444

Unknown Individual is a healthcare provider. based in Irvington, New Jersey. specializing in Surgery Physician. They hold a License No. 25MA02945600 (NJ). The NPI Number for Unknown Individual is 1164571444

Main info

Organization
Inactive
60 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1164571444
Phone
(973) 371-8300
Address
50 UNION AVE
Deactivation Date
1 March 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6067898531
Graduation Year
1966 (60 years ago)
PAC ID
0345269338
Group Practice PAC ID
3476858606
Professional Enrollment ID
I20170926004213
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

Loading map...

Provider Addresses for Unknown Individual

  • 50, Union Avenue, Irvington, Essex County, New Jersey, 07111, United States

    SUITE 604

    IRVINGTON, NJ 071113262

    Phone: (973) 371-8300

    Fax: (973) 374-2936

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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 07111)

Loading plans...

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: 3476858606View full group profile

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1164571444 when you need to reference Unknown Individual in forms, claims, or directories.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Surgery Physician. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Irvington, New Jersey because that is what the record indicates for Unknown Individual.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

Similar Providers

DR. MICHAEL A PONTORIERO (M.D.)

Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Central Avenue, Westfield, Union County, New Jersey, 07090, United States
NPI: 1275536765

DR. JEFFREY H CHEN (M.D.)

Surgery Physician
7660 E PARHAM RD
NPI: 1932102258

Unknown Individual

Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Park Avenue, Plainfield, Will County, Illinois, 60544, United States
NPI: 1750384178
Essex Avenue, Jefferson Park, Metuchen, Middlesex County, New Jersey, 08840, United States
NPI: 1942204904

SUSAN A MCMANUS (M.D.)

Surgery Physician
PO BOX 8500-3240
NPI: 1316941370
9 BROADWAY
NPI: 1629073911
PO BOX 16149
NPI: 1366447203