Unknown Individual – Psychiatry Physician, NPI 1336109495

Unknown Individual is a healthcare provider. based in Chester, Pennsylvania. specializing in Psychiatry Physician. They hold a License No. MD437507 (PA). The NPI Number for Unknown Individual is 1336109495

Main info

Organization
Inactive
65 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1336109495
Phone
(610) 497-7548
Address
2602 W 9TH ST
Deactivation Date
23 January 2025

Doctor Profile

Medical School Name
GEORGE WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
1961 (65 years ago)
PAC ID
7012921158
Group Practice PAC ID
5698065142
Professional Enrollment ID
I20090806000397
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 2602, West 9th Street, South Chester, Chester, Delaware County, Pennsylvania, 19013, United States

    CHESTER, PA 190132040

    Phone: (610) 497-7548

    Fax: (610) 497-7487

    Type: Mailing

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

    CHESTER, PA 190133902

    Phone: (610) 874-5257

    Fax: (610) 874-7241

    Type: Location

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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes2415$0
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Insurance plans in this area (ZIP 19013)

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Provider's Procedures

Unknown Individual performs procedures in Psychiatry Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PSYCHIATRYPA90833Psychotherapy, 30 minutes with patient and/or family member30434

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: 5698065142View full group profile

Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1336109495 if you need a stable reference for Unknown Individual.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
What kind of provider is Unknown Individual?
The page reflects Psychiatry Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Chester, Pennsylvania for Unknown Individual; expand the address list for detail.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1336109495. Always confirm identity and privileges with the practice and licensing boards.

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