Unknown Individual – Surgery Physician, NPI 1487730719

Unknown Individual is a healthcare provider. based in Wayne, New Jersey. specializing in Surgery Physician. They hold a License No. 25MA05260900 (NJ). The NPI Number for Unknown Individual is 1487730719

Main info

Organization
Inactive
60 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1487730719
Phone
(973) 826-8540
Address
PO BOX 4059
Deactivation Date
4 December 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9738268080
Graduation Year
1966 (60 years ago)
PAC ID
9335310093
Group Practice PAC ID
9234375932
Professional Enrollment ID
I20110929000349
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

Provider Addresses for Unknown Individual

  • Wayne Municipal Airport, East 14th Street, Wayne County, Nebraska, 68787, United States

    WAYNE, NJ 074744059

    Phone: (973) 826-8540

    Fax: (855) 834-5434

    Type: Mailing

  • 695 ROUTE 46 W

    SUITE 400A

    FAIRFIELD, NJ 070041592

    Phone: (973) 826-8080

    Fax: (855) 834-5434

    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 07474)

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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: 9234375932View full group profile
NameSpecialtyState
DR. RICHARD J MASTERSON (MD)
-NJ
ROMAN MATSOUK (PA-C)
-NJ

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 1487730719.
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 Surgery Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Wayne, New Jersey in the same public data insurers reference.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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