Unknown Individual – Infectious Disease Physician, NPI 1104850569

Unknown Individual is a healthcare provider. based in Chester, Pennsylvania. specializing in Infectious Disease Physician. They hold a License No. MD018497E (PA). The NPI Number for Unknown Individual is 1104850569

Main info

Organization
Inactive
51 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1104850569
Phone
(610) 874-1253
Address
1 MEDICAL CENTER BLVD
Deactivation Date
11 September 2024

Doctor Profile

Medical School Name
HAHNEMAN MEDICAL COLLEGE OF THE PACIFIC
Secondary Phone
6108741253
Graduation Year
1975 (51 years ago)
PAC ID
6103806088
Group Practice PAC ID
6507770856
Professional Enrollment ID
I20040726000023
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

  • The Boulevard, Riverlights, Little Chester, Derby, East Midlands, England, DE1 2BB, United Kingdom

    ACP-331

    CHESTER, PA 190133902

    Phone: (610) 874-1253

    Fax: (610) 619-8429

    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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 19013)

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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: 6507770856View full group profile
NameSpecialtyState
DR. HAIMAVATHI BHAT (D.O., M.P.H.)
-PA

Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1104850569.
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 type of care does Unknown Individual provide?
Unknown Individual's profile centers on Infectious Disease Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Chester, Pennsylvania in registry-derived data.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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