Unknown Individual – Child & Adolescent Psychiatry Physician, NPI 1033243779

Unknown Individual is a healthcare provider. based in Blue bell, Pennsylvania. specializing in Child & Adolescent Psychiatry Physician. They hold a License No. MD020058E (PA). The NPI Number for Unknown Individual is 1033243779

Main info

Organization
Inactive
52 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1033243779
Phone
(610) 275-8616
Address
1030 SKIPPACK PIKE
Deactivation Date
15 January 2026

Doctor Profile

Medical School Name
HOWARD UNIVERSITY COLLEGE OF MEDICINE
Secondary Phone
6109172200
Graduation Year
1974 (52 years ago)
PAC ID
3274812680
Group Practice PAC ID
9537055405
Professional Enrollment ID
I20161107002316
Data current as of
19 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

  • 1030 SKIPPACK PIKE

    BLUE BELL, PA 194221537

    Phone: (610) 275-8616

    Fax: (610) 275-0896

    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)

CMS reports 2 Open Payments records for all available years, with a total value of $38.

Total Amount is formed as General ($38) + Research ($0) + Ownership ($0) = $38.

Last reported payment date: 2024-10-31 • Largest payer in this snapshot: Teva Pharmaceuticals USA, Inc. ($38).

Total Amount

$38

General + Research + Ownership

Payments

2

Total payment records

General Amount

$38

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-31

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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90834Psychotherapy, 45 minutes29161$0
90837Psychotherapy, 1 hour15034$0
90832Psychotherapy, 30 minutes12288$0
99213Established patient office or other outpatient visit, 20-29 minutes5018$0
90833Psychotherapy with evaluation and management visit, 30 minutes4917$0
View full utilization report →

Insurance plans in this area (ZIP 19422)

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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: 9537055405View full group profile
NameSpecialtyState
P S Y C H I A T R YPA
Nurse PractitionerPA
-PA
Clinical Social WorkerPA
-PA
Nurse PractitionerPA
P S Y C H I A T R YPA
Nurse PractitionerPA

Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1033243779.
What dates should I check for Unknown Individual's activity?
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 Child & Adolescent Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Blue Bell, Pennsylvania may find Unknown Individual in results; validate coverage separately.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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