Unknown Individual – Medical Oncology Physician, NPI 1023030368

Unknown Individual is a healthcare provider. based in Philadelphia, Pennsylvania. specializing in Medical Oncology Physician. They hold a License No. MD008521E (PA). The NPI Number for Unknown Individual is 1023030368

Main info

Organization
Inactive
55 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1023030368
Phone
(215) 955-8874
Address
925 CHESTNUT ST
Deactivation Date
30 January 2025

Doctor Profile

Medical School Name
JEFFERSON MEDICAL COLLEGE OF THOMAS JEFFERSON UNIVERSITY
Secondary Phone
2154812400
Graduation Year
1971 (55 years ago)
PAC ID
4880645738
Group Practice PAC ID
3274437736
Professional Enrollment ID
I20050208000618
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Red Earth Farm CSA drop site, 925, Chestnut Street, Society Hill, Philadelphia, Philadelphia County, Pennsylvania, 19139, United States

    SUITE 320A

    PHILADELPHIA, PA 191074216

    Phone: (215) 955-8874

    Fax: (215) 955-2340

    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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes1212$0
View full utilization report →

Insurance plans in this area (ZIP 19107)

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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: 3274437736View full group profile

Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1023030368.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What does the directory say Unknown Individual does?
Insurance directories may phrase it differently, but here Unknown Individual maps to Medical Oncology Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Philadelphia, Pennsylvania?
If you are local to Philadelphia, Pennsylvania, Unknown Individual may be relevant to your search.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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