Unknown Individual – Specialist, NPI 1679511844

Unknown Individual is a healthcare provider. based in Holmdel, New Jersey. specializing in Specialist. They hold a License No. 25MA03850300 (NJ). The NPI Number for Unknown Individual is 1679511844

Main info

Organization
Inactive
54 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1679511844
Phone
(732) 264-0210
Address
PO BOX 370
Deactivation Date
21 August 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7322640210
Graduation Year
1972 (54 years ago)
PAC ID
7517953433
Group Practice PAC ID
9638165541
Professional Enrollment ID
I20050919000537
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

  • PO BOX 370

    HOLMDEL, NJ 077330370

    Phone: (732) 264-0210

    Fax: (732) 888-9214

    Type: Mailing

  • 717, North Beers Street, Morrell Corners, Holmdel Township, Monmouth County, New Jersey, 07733, United States

    HOLMDEL, NJ 077331525

    Phone: (732) 264-0210

    Fax: (732) 888-9214

    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 07733)

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Provider's Procedures

Unknown Individual performs procedures in Specialist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
CARDIOVASCULAR DISEASE (CARDIOLOGY)NJ85610Blood test, clotting time10630

Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1679511844 as the unique 10-digit identifier.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Other Service Providers in the directory — Clinical services aligned with this taxonomy classification.
Where in New Jersey is Unknown Individual registered?
Use Holmdel, 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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