Unknown Individual – Family Medicine Physician, NPI 1396723995

Unknown Individual is a healthcare provider. based in Hermitage, Pennsylvania. specializing in Family Medicine Physician. They hold a License No. MD027449E (PA). The NPI Number for Unknown Individual is 1396723995

Main info

Organization
Inactive
45 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1396723995
Phone
(724) 983-1355
Address
850 S HERMITAGE RD
Deactivation Date
1 May 2024

Doctor Profile

Medical School Name
TEMPLE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
7246543006
Graduation Year
1981 (45 years ago)
PAC ID
9133173610
Group Practice PAC ID
9638350093
Professional Enrollment ID
I20091106000069
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

  • Hermitage Road, Hermitage, Nashville, Davidson County, Tennessee, 37138, United States

    SUITE B15

    HERMITAGE, PA 161483679

    Phone: (724) 983-1355

    Fax: (724) 981-1605

    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 16148)

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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: 9638350093View full group profile
NameSpecialtyState
Nurse PractitionerPA
Emergency MedicineDE
Nurse PractitionerPA
Nurse PractitionerPA
Nurse PractitionerOH
-OH
-PA
Emergency Medicine, Internal MedicinePA
Nurse PractitionerPA

Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1396723995.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Hermitage, Pennsylvania for Unknown Individual; download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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