Unknown Individual – Psychiatry Physician, NPI 1639445752

Unknown Individual is a healthcare provider. based in Valhalla, New York. specializing in Psychiatry Physician. They hold a License No. MD60788033 (WA). The NPI Number for Unknown Individual is 1639445752

Main info

Organization
Inactive
14 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1639445752
Phone
Not provided
Address
100 WOODS RD
Deactivation Date
29 May 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3603561890
Graduation Year
2012 (14 years ago)
PAC ID
5294960019
Group Practice PAC ID
0547514549
Professional Enrollment ID
I20181212002510
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:0State licenses:2Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 100 WOODS RD

    VALHALLA, NY 105951530

    Phone:

    Type: Mailing

  • 10200 NE 132ND ST

    KIRKLAND, WA 980342831

    Phone: (800) 435-7221

    Fax: (425) 814-5648

    Type: Location

  • 1400 E OAKLAND PARK BLVD STE 210

    OAKLAND PARK, FL 333344400

    Phone: (954) 561-6222

    Fax: (954) 990-7650

    Type: Mailing

  • 7261 Sheridan St Ste 100B

    Hollywood, FL 330242708

    Phone: (954) 561-6222

    Fax: (954) 990-7650

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 16 Open Payments records for all available years, with a total value of $347.

Total Amount is formed as General ($347) + Research ($0) + Ownership ($0) = $347.

Last reported payment date: 2024-11-18 • Largest payer in this snapshot: Vanda Pharmaceuticals Inc. ($57).

Total Amount

$347

General + Research + Ownership

Payments

16

Total payment records

General Amount

$347

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-18

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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 10595)

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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: 0547514549View full group profile

Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?
The NPI 1639445752 uniquely identifies Unknown Individual in U.S. healthcare data.
What does inactive NPI status mean for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Psychiatry Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Valhalla, New York in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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