Unknown Individual – Anesthesiology Physician, NPI 1245201540

Unknown Individual is a healthcare provider. based in Millburn, New Jersey. specializing in Anesthesiology Physician. They hold a License No. 25MA04109600 (NJ). The NPI Number for Unknown Individual is 1245201540

Main info

Organization
Inactive
47 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1245201540
Phone
(201) 943-0034
Address
PO BOX 724
Deactivation Date
17 January 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9735335094
Graduation Year
1979 (47 years ago)
PAC ID
2365479177
Group Practice PAC ID
0042112500
Professional Enrollment ID
I20050725000089
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

  • PO BOX 724

    MILLBURN, NJ 070410724

    Phone: (201) 943-0034

    Fax: (201) 943-8105

    Type: Mailing

  • Newark Beth Israel Medical Center, 201, Lyons Avenue, Newark, Essex County, New Jersey, 07112, United States

    NEWARK, NJ 071122027

    Phone: (201) 943-0034

    Fax: (201) 943-8105

    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 07041)

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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: 0042112500View full group profile

Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1245201540 if you need a stable reference for Unknown Individual.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Anesthesiology Physician. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Millburn, New Jersey because that is what the record indicates for Unknown Individual.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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Unknown Individual

Anesthesiology Physician
PO BOX 724
NPI: 1922078799