Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1356319289

Certified Registered Nurse Anesthetist

Unknown Individual is a healthcare provider. based in Johnstown, Pennsylvania. specializing in Certified Registered Nurse Anesthetist. They hold a License No. RN223895L (PA). The NPI Number for Unknown Individual is 1356319289

Main info

Organization

Inactive

45 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1356319289

Phone

(814) 266-5795

Address

1318 EISENHOWER BLVD.

Deactivation Date

2 February 2022

Doctor Profile

Medical School Name

OTHER

Secondary Phone

8142666027

Graduation Year

1981 (45 years ago)

PAC ID

2062491392

Group Practice PAC ID

7719953041

Professional Enrollment ID

I20040719001186

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

Elite Dentistry of Johnstown, Eisenhower Boulevard, Richland Township, Cambria County, Pennsylvania, 15904, United States
JOHNSTOWN, PA 159043307
Phone: (814) 266-5795
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 15904)

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Provider's Procedures

Unknown Individual performs procedures in Certified Registered Nurse Anesthetist. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
CERTIFIED REGISTERED NURSE ANESTHET	PA	00142	Anesthesia for lens surgery	175	159

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: 7719953041View full group profile

Name	Specialty	State
DR. JOSEPH R POLITO (MD)	-	PA
RICHARD C IRWIN (OD)	-	PA

Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?

You can start verification with NPI 1356319289 for Unknown Individual, then check state licensing separately.

Why is Unknown Individual marked inactive in the NPI directory?

The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.

What healthcare role does Unknown Individual hold?

Scheduling teams often label Unknown Individual under Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.

Where should I expect Unknown Individual on a map?

Expect Johnstown, Pennsylvania as a primary anchor for Unknown Individual unless the record lists multiple sites.

What does 'Individual Provider' mean on this profile?

Entity type tells you whether the number belongs to a person or an organization.