Unknown Individual – Internal Medicine Physician, NPI 1891831244

Unknown Individual is a healthcare provider. based in Oradell, New Jersey. specializing in Internal Medicine Physician. They hold a License No. MB45751 (NJ). The NPI Number for Unknown Individual is 1891831244

Main info

Organization
Inactive
43 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1891831244
Phone
(201) 967-7130
Address
550 KINDERKAMACK RD
Deactivation Date
15 December 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2018644477
Graduation Year
1983 (43 years ago)
PAC ID
3072562628
Group Practice PAC ID
4284647868
Professional Enrollment ID
I20111025000794
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

  • Kinderkamack Road, Oradell, Bergen County, New Jersey, 07642, United States

    SUITE 201

    ORADELL, NJ 076491500

    Phone: (201) 967-7130

    Fax: (201) 599-2270

    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 07649)

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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: 4284647868View full group profile

Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1891831244 as the unique 10-digit identifier.
Is Unknown Individual still active if the NPI shows inactive?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Oradell, New Jersey.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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