Unknown Individual – Medical Physician Assistant, NPI 1801967013

Unknown Individual is a healthcare provider. based in Berkeley heights, New Jersey. specializing in Medical Physician Assistant. They hold a License No. 25MP00027400 (NJ). The NPI Number for Unknown Individual is 1801967013

Main info

Organization
Inactive
44 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1801967013
Phone
(908) 273-4300
Address
1 DIAMOND HILL RD
Deactivation Date
24 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9082734300
Graduation Year
1982 (44 years ago)
PAC ID
3375722077
Group Practice PAC ID
5395642276
Professional Enrollment ID
I20110127000343
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

  • Walgreens, 1, Diamond Hill Road, Berkeley Heights, Union County, New Jersey, 07922, United States

    SUMMIT MEDICAL GROUP

    BERKELEY HEIGHTS, NJ 079222104

    Phone: (908) 273-4300

    Fax: (908) 277-8706

    Mailing address matches the actual address.

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 07922)

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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: 5395642276View full group profile

Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1801967013; it appears in the national provider directory.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
What kind of provider is Unknown Individual?
The page reflects Medical Physician Assistant for Unknown Individual. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in New Jersey?
You will see Berkeley Heights, New Jersey on file for Unknown Individual alongside any extra practice locations.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1801967013. Always confirm identity and privileges with the practice and licensing boards.

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