Unknown Individual – Family Medicine Physician, NPI 1457409492

Unknown Individual is a healthcare provider. based in Galloway, New Jersey. specializing in Family Medicine Physician. They hold a License No. 25MA05833400 (NJ). The NPI Number for Unknown Individual is 1457409492

Main info

Organization
Inactive
49 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1457409492
Phone
(609) 652-2033
Address
415 CHRIS GAUPP DR
Deactivation Date
17 May 2021

Doctor Profile

Medical School Name
JEFFERSON MEDICAL COLLEGE OF THOMAS JEFFERSON UNIVERSITY
Secondary Phone
-
Graduation Year
1977 (49 years ago)
PAC ID
3072509678
Professional Enrollment ID
I20040421000170
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

  • 415, Chris Gaupp Drive, Monticello Estates, Pinehurst, Galloway Township, Atlantic County, New Jersey, 08205, United States

    SUITE C2

    GALLOWAY, NJ 082054440

    Phone: (609) 652-2033

    Fax: (609) 652-3318

    Type: Location

  • Chris Gaupp Drive, University Park, Pinehurst, Galloway Township, Atlantic County, New Jersey, 08205, United States

    SUITE C2

    GALLOWAY, NJ 082054440

    Phone: (609) 652-2033

    Fax: (609) 652-3318

    Type: Mailing

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 08205)

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Reviews

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Frequently asked questions

What is the standard ID for Unknown Individual in the U.S.?
In the U.S., Unknown Individual is identified by NPI 1457409492.
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.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Family Medicine Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Galloway, New Jersey in registry-derived data.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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