Unknown Individual – Surgery Physician, NPI 1346202363

Unknown Individual is a healthcare provider. based in Haddon heights, New Jersey. specializing in Surgery Physician. They hold a License No. 25MA06839200 (NJ). The NPI Number for Unknown Individual is 1346202363

Main info

Organization
Inactive
38 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1346202363
Phone
(856) 546-3900
Address
120 WHITE HORSE PIKE STE 103B
Deactivation Date
21 February 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8565463900
Graduation Year
1988 (38 years ago)
PAC ID
6204818396
Group Practice PAC ID
1557260122
Professional Enrollment ID
I20180627003267

Contacts

Secure Messaging
vbondar139038@directvirtua.org
SOAP Endpoint
https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness85
Years active:0State licenses:2Other namesUpdated within 12 months

Provider Addresses for Unknown Individual

  • 120 WHITE HORSE PIKE STE 103B

    HADDON HEIGHTS, NJ 080351938

    Phone: (856) 546-3900

    Fax: (856) 546-3908

    Type: Location

  • 410, Lippincott Drive, Marlton, Evesham Township, Burlington County, New Jersey, 08053, United States

    MARLTON, NJ 080534197

    Phone: (856) 355-0340

    Fax: (856) 355-0330

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $15.

Total Amount is formed as General ($15) + Research ($0) + Ownership ($0) = $15.

Last reported payment date: 2023-04-25 • Largest payer in this snapshot: Cook Medical LLC ($15).

Total Amount

$15

General + Research + Ownership

Payments

1

Total payment records

General Amount

$15

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
Cook Medical LLC$15
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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 08035)

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: 1557260122View 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

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1346202363 on file in the registry.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Surgery Physician. Clinical services aligned with this taxonomy classification.
Where in New Jersey is Unknown Individual registered?
Use Haddon Heights, New Jersey as the headline location for Unknown Individual here.
Does Unknown Individual accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

Similar Providers

LISA ANN MEDVETZ (MD)

Surgery Physician
600 Maple Ave Ste 1
NPI: 1467451823

THOMAS GRABIAK (M.D.)

Surgery Physician
500, Grove Street, Haddon Heights, Camden County, New Jersey, 08035, United States
NPI: 1710988852

LOURDES MEDICAL ASSOCIATES PA

Family Medicine Physician
500, Grove Street, Haddon Heights, Camden County, New Jersey, 08035, United States
NPI: 1568441541
338 HURFFVILLE CROSSKEYS RD
NPI: 1861462939

DR. PAUL K DAVIS (M.D.)

Surgery Physician
1, Brace Road, Erlton, Cherry Hill Township, Camden County, New Jersey, 08034, United States
NPI: 1255301552
500, Grove Street, Haddon Heights, Camden County, New Jersey, 08035, United States
NPI: 1134185846

HADDON SURGICAL ASSOC PA

Surgery Physician
White Horse Pike, Haddon Heights, Camden County, New Jersey, 08007, United States
NPI: 1063461374

Unknown Individual

Surgery Physician
1000, Kings Highway, Haddon Heights, Camden County, New Jersey, 08035, United States
NPI: 1811920622

KENNETH H LEESE (M.D.)

Surgery Physician
500, Grove Street, Haddon Heights, Camden County, New Jersey, 08035, United States
NPI: 1316964356