Unknown Individual – Physician Assistant, NPI 1093723181

Unknown Individual is a healthcare provider. based in Easton, Pennsylvania. specializing in Physician Assistant. They hold a License No. MA055199 (PA). The NPI Number for Unknown Individual is 1093723181

Main info

Organization
Inactive
22 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1093723181
Phone
(610) 515-9994
Address
3729 EASTON NAZARETH HWY
Deactivation Date
20 July 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6105598192
Graduation Year
2004 (22 years ago)
PAC ID
3577695238
Group Practice PAC ID
7416118005
Professional Enrollment ID
I20120409000227
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

  • 3729, Easton-Nazareth Highway, Hollo, Lower Nazareth Township, Northampton County, Pennsylvania, 18045, United States

    SUITE 203

    EASTON, PA 180458344

    Phone: (610) 515-9994

    Fax: (610) 515-9997

    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 1 Open Payments records for all available years, with a total value of $25.

Total Amount is formed as General ($25) + Research ($0) + Ownership ($0) = $25.

Last reported payment date: 2023-05-17 • Largest payer in this snapshot: DePuy Synthes Sales Inc. ($25).

Total Amount

$25

General + Research + Ownership

Payments

1

Total payment records

General Amount

$25

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-05-17

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
DePuy Synthes Sales Inc.$25
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 18045)

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Provider's Procedures

Unknown Individual performs procedures in Physician Assistant. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICIAN ASSISTANTPA20610Aspiration and/or injection of large joint or joint capsule15974

Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1093723181.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Physician Assistant. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Easton, Pennsylvania. Check all listed addresses for suites or satellite offices.
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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