Unknown Individual – Internal Medicine Physician, NPI 1457573586

Unknown Individual is a healthcare provider. based in Teaneck, New Jersey. specializing in Internal Medicine Physician. They hold a License No. 25MA08992300 (NJ). The NPI Number for Unknown Individual is 1457573586

Main info

Organization
Inactive
19 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1457573586
Phone
(201) 833-7265
Address
718 TEANECK ROAD
Deactivation Date
28 June 2023

Doctor Profile

Medical School Name
RUTGERS NEW JERSEY MEDICAL SCHOOL
Secondary Phone
3054702929
Graduation Year
2007 (19 years ago)
PAC ID
2264557396
Group Practice PAC ID
6608137252
Professional Enrollment ID
I20111101000241
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Holy Name Medical Center, 718, Teaneck Road, Teaneck Township, Bergen County, New Jersey, 07666, United States

    HEALTH PARTNER SERVICES

    TEANECK, NJ 076660000

    Phone: (201) 833-7265

    Fax: (201) 227-6207

    Type: Mailing

  • 408, 37th Street, Union City, Hudson County, New Jersey, 07087, United States

    EXCELCARE MEDICAL ASSOCIATES, PA

    UNION CITY, NJ 070870000

    Phone: (201) 864-4477

    Fax: (201) 864-9727

    Type: Location

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 $15.

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

Last reported payment date: 2023-05-31 • Largest payer in this snapshot: GlaxoSmithKline, 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

2023-05-31

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
GlaxoSmithKline, 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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes1916$0
View full utilization report →

Insurance plans in this area (ZIP 07666)

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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: 6608137252View full group profile

Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1457573586 as the unique 10-digit identifier.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Internal Medicine Physician in the directory — Clinical services aligned with this taxonomy classification.
Where in New Jersey is Unknown Individual registered?
Use Teaneck, 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.

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