Unknown Individual – Psychiatry Physician, NPI 1770537797

Unknown Individual is a healthcare provider. based in Newark, New Jersey. specializing in Psychiatry Physician. They hold a License No. 25MA08004400 (NJ). The NPI Number for Unknown Individual is 1770537797

Main info

Organization
Inactive
32 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1770537797
Phone
(973) 971-5595
Address
PO BOX 23831
Deactivation Date
7 June 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2018485500
Graduation Year
1994 (32 years ago)
PAC ID
6709897168
Group Practice PAC ID
7618887340
Professional Enrollment ID
I20060522000164
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 23831

    NEWARK, NJ 071890001

    Phone: (973) 971-5595

    Type: Mailing

  • Overlook Medical Center, 99, Beauvoir Avenue, Overlook, Summit, Union County, New Jersey, 07901, United States

    SUMMIT, NJ 079013533

    Phone: (973) 971-5595

    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 07189)

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Provider's Procedures

Unknown Individual performs procedures in Psychiatry Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PSYCHIATRYNJ90833Psychotherapy, 30 minutes with patient and/or family member7034

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: 7618887340View full group profile
NameSpecialtyState
P S Y C H I A T R YNJ
Nurse PractitionerNJ
P S Y C H I A T R YNJ
Physical Medicine And RehabilitationPA
Nurse PractitionerMA
Nurse PractitionerNJ
Nurse PractitionerNJ
P S Y C H I A T R YNJ

Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1770537797 in the public NPI dataset.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Psychiatry Physician in this dataset. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Newark, New Jersey may find Unknown Individual in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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