Unknown Individual – Surgery Physician, NPI 1073533394

Unknown Individual is a healthcare provider. based in Philadelphia, Pennsylvania. specializing in Surgery Physician. They hold a License No. MD418549 (PA). The NPI Number for Unknown Individual is 1073533394

Main info

Organization
Inactive
31 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1073533394
Phone
Not provided
Address
615 CHESTNUT ST
Deactivation Date
19 December 2024

Doctor Profile

Medical School Name
NEW YORK UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
7322352465
Graduation Year
1995 (31 years ago)
PAC ID
9032184627
Group Practice PAC ID
7911986849
Professional Enrollment ID
I20190916002269
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

  • Continental, 615, Chestnut Street, Society Hill, Philadelphia, Philadelphia County, Pennsylvania, 19106-9997, United States

    14TH FLOOR, CENTRAL ENROLLMENT

    PHILADELPHIA, PA 191064404

    Phone:

    Type: Mailing

  • Dunkin' Donuts, 1100, Walnut Street, Rittenhouse Square, Philadelphia, Philadelphia County, Pennsylvania, 19104, United States

    MOB, 5TH FLOOR

    PHILADELPHIA, PA 191075563

    Phone: (215) 955-6750

    Fax: (215) 923-8222

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 8 Open Payments records for all available years, with a total value of $12,600.

Total Amount is formed as General ($12,600) + Research ($0) + Ownership ($0) = $12,600.

Last reported payment date: 2024-10-22 • Largest payer in this snapshot: Cardinal Health 414 LLC ($12,600).

Total Amount

$12,600

General + Research + Ownership

Payments

8

Total payment records

General Amount

$12,600

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-22

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Cardinal Health 414 LLC$12,600
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
99213Established patient office or other outpatient visit, 20-29 minutes8053$0
99204New patient office or other outpatient visit, 45-59 minutes5959$0
11606Removal of cancer skin growth of body, arms, or legs, more than 4.0 cm4440$0
99203New patient office or other outpatient visit, 30-44 minutes2929$0
12032Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm2727$0
View full utilization report →

Insurance plans in this area (ZIP 19106)

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Provider's Procedures

Unknown Individual performs procedures in Surgery Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
GENERAL SURGERYPA38900Lymph node imaging during surgery4040

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: 7911986849View full group profile

Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?
The NPI 1073533394 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 services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Surgery Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Philadelphia, Pennsylvania in the same public data insurers reference.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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