Unknown Individual – Diagnostic Radiology Physician, NPI 1023194628

Unknown Individual is a healthcare provider. based in East stroudsburg, Pennsylvania. specializing in Diagnostic Radiology Physician. They hold a License No. MD424406 (PA). The NPI Number for Unknown Individual is 1023194628

Main info

Organization
Inactive
27 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1023194628
Phone
(570) 421-8196
Address
RR 2 BOX 2091C
Deactivation Date
29 April 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6107701606
Graduation Year
1999 (27 years ago)
PAC ID
5991703746
Group Practice PAC ID
1557265212
Professional Enrollment ID
I20061110000200
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

Provider Addresses for Unknown Individual

  • RR 2 BOX 2091C

    EAST STROUDSBURG, PA 183019629

    Phone: (570) 421-8196

    Fax: (570) 476-6213

    Type: Mailing

  • 1200 S Cedar Crest Blvd

    Allentown, PA 181036202

    Phone: (610) 402-8080

    Type: Location

  • Lehigh Valley Hospital-Pocono, 206, East Brown Street, East Stroudsburg, Monroe County, Pennsylvania, 18301, United States

    EAST STROUDSBURG, PA 183013006

    Phone: (570) 421-4000

    Fax: (570) 476-6213

    Type: Location

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
70450Ct scan head or brain without contrast109106$0
71045X-ray of chest, 1 view7063$0
72148Mri scan of lower spinal canal without contrast3939$0
72125Ct scan of upper spine without contrast3838$0
71046X-ray of chest, 2 views2525$0
View full utilization report →

Insurance plans in this area (ZIP 18301)

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Provider's Procedures

Unknown Individual performs procedures in Diagnostic Radiology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DIAGNOSTIC RADIOLOGYPA71010X-ray of chest, 1 view, front769651
DIAGNOSTIC RADIOLOGYPA71250CT scan chest492455
DIAGNOSTIC RADIOLOGYPA73110X-ray of wrist, minimum of 3 views3528
DIAGNOSTIC RADIOLOGYPA73140X-ray of fingers, minimum of 2 views1515
DIAGNOSTIC RADIOLOGYPA73630X-ray of foot, minimum of 3 views6357
DIAGNOSTIC RADIOLOGYPA74177CT scan of abdomen and pelvis with contrast3332
DIAGNOSTIC RADIOLOGYPA76830Ultrasound pelvis through vagina1313
DIAGNOSTIC RADIOLOGYPA78452Nuclear medicine study of vessels of heart using drugs or exercise multiple studies1717
DIAGNOSTIC RADIOLOGYPA78815Nuclear medicine study with CT imaging skull base to mid-thigh1111
DIAGNOSTIC RADIOLOGYPA93926Ultrasound study of arteries and arterial grafts of one leg or limited1414
DIAGNOSTIC RADIOLOGYPA93971Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers9189

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: 1557265212View full group profile
NameSpecialtyState
Diagnostic RadiologyPA
-PA
-PA
Diagnostic RadiologyNJ
Diagnostic RadiologyPA
Diagnostic RadiologyIA
-PA
Diagnostic RadiologyPA
Interventional RadiologyMD
-PA

Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1023194628.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Diagnostic Radiology Physician. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect East Stroudsburg, Pennsylvania as a primary anchor for Unknown Individual unless the record lists multiple sites.
Why does Unknown Individual have multiple addresses?
3 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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