Unknown Individual – Family Medicine Physician, NPI 1295796936

Unknown Individual is a healthcare provider. based in Exton, Pennsylvania. specializing in Family Medicine Physician. They hold a License No. OS-009044-L (PA). The NPI Number for Unknown Individual is 1295796936

Main info

Organization
Inactive
33 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1295796936
Phone
(610) 594-7590
Address
412 CREAMERY WAY STE 400
Deactivation Date
7 August 2025

Doctor Profile

Medical School Name
PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
6104308200
Graduation Year
1993 (33 years ago)
PAC ID
1355314022
Group Practice PAC ID
5294707634
Professional Enrollment ID
I20110518000400
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

  • 412 CREAMERY WAY STE 400

    EXTON, PA 193412551

    Phone: (610) 594-7590

    Fax: (610) 594-2625

    Type: Mailing

  • 201, Wallace Avenue, Downingtown, Chester County, Pennsylvania, 19335, United States

    DOWNINGTOWN, PA 19335

    Phone: (610) 873-2700

    Fax: (610) 594-2625

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 104 Open Payments records for all available years, with a total value of $1,967.

Total Amount is formed as General ($1,967) + Research ($0) + Ownership ($0) = $1,967.

Last reported payment date: 2024-12-20 • Largest payer in this snapshot: ABBVIE INC. ($447).

Total Amount

$1,967

General + Research + Ownership

Payments

104

Total payment records

General Amount

$1,967

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-20

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
99214Established patient office or other outpatient visit, 30-39 minutes544295$0
G0442Annual alcohol misuse screening, 5 to 15 minutes261261$0
96160Administration and interpretation of patient-focused health risk assessment259258$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit226226$0
G0444Annual depression screening, 5 to 15 minutes225225$0
View full utilization report →

Insurance plans in this area (ZIP 19341)

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Provider's Procedures

Unknown Individual performs procedures in Family Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINEPA90670Pneumococcal vaccine for injection into muscle6868

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: 5294707634View full group profile

Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1295796936 on file in the registry.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Exton?
Public fields place Unknown Individual around Exton, Pennsylvania. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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