Unknown Individual – Surgery Physician, NPI 1508975350

Unknown Individual is a healthcare provider. based in Englewood cliffs, New Jersey. specializing in Surgery Physician. They hold a License No. 25MA02282400 (NJ). The NPI Number for Unknown Individual is 1508975350

Main info

Organization
Inactive
65 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1508975350
Phone
(201) 945-6500
Address
PO BOX 1546
Deactivation Date
6 October 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2019456500
Graduation Year
1961 (65 years ago)
PAC ID
1557491719
Group Practice PAC ID
0042230740
Professional Enrollment ID
I20100615000014
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

  • PO BOX 1546

    ENGLEWOOD CLIFFS, NJ 07632

    Phone: (201) 945-6500

    Fax: (201) 945-1157

    Type: Mailing

  • 663, Palisade Avenue, Grantwood, Cliffside Park, Bergen County, New Jersey, 07010, United States

    STE 101

    CLIFFSIDE PARK, NJ 07010

    Phone: (201) 945-6500

    Fax: (201) 945-1157

    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 $39.

Total Amount is formed as General ($39) + Research ($0) + Ownership ($0) = $39.

Last reported payment date: 2024-01-09 • Largest payer in this snapshot: Medtronic, Inc. ($39).

Total Amount

$39

General + Research + Ownership

Payments

1

Total payment records

General Amount

$39

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-01-09

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Medtronic, Inc.$39
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 07632)

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Provider's Procedures

Unknown Individual performs procedures in Surgery Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
GENERAL SURGERYNJ11042Removal of skin and tissue first 20 sq cm or less2221

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: 0042230740View full group profile
NameSpecialtyState
Gastroenterology, Internal MedicineNJ
-NY
-NY
Diagnostic RadiologyNY
-NJ
D E R M A T O L O G YNY
Internal MedicineNJ
General PracticeNJ

Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1508975350 — the number used across U.S. healthcare to identify this provider.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Surgery Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Englewood Cliffs?
Public fields place Unknown Individual around Englewood Cliffs, New Jersey. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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