Unknown Individual – Internal Medicine Physician, NPI 1154328342

Unknown Individual is a healthcare provider. based in Ogdensburg, New York. specializing in Internal Medicine Physician. They hold a License No. 099990 (NY). The NPI Number for Unknown Individual is 1154328342

Main info

Organization
Inactive
64 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1154328342
Phone
(315) 393-2295
Address
1231 CONGRESS ST
Deactivation Date
11 December 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1962 (64 years ago)
PAC ID
0042482127
Professional Enrollment ID
I20111014000160
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

  • 1231, Congress Street, Ogdensburg, Saint Lawrence County, New York, 13669, United States

    BOX 308

    OGDENSBURG, NY 136693268

    Phone: (315) 393-2295

    Fax: (315) 393-9604

    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 13669)

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Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1154328342.
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.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Ogdensburg?
Unknown Individual currently maps to Ogdensburg, New York in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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