Unknown Individual – Otolaryngology Physician, NPI 1396765186

Unknown Individual is a healthcare provider. based in Wyomissing, Pennsylvania. specializing in Otolaryngology Physician. They hold a License No. MD-028715-L (PA). The NPI Number for Unknown Individual is 1396765186

Main info

Organization
Inactive
70 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1396765186
Phone
(610) 376-3738
Address
1 GRANITE POINT DR
Deactivation Date
26 March 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6103769728
Graduation Year
1956 (70 years ago)
PAC ID
7416094339
Group Practice PAC ID
5799773933
Professional Enrollment ID
I20091027000140
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

  • 1, Granite Point Drive, Wyomissing, Berks County, Pennsylvania, 19610, United States

    SUITE 300

    WYOMISSING, PA 196101986

    Phone: (610) 376-3738

    Fax: (610) 376-4780

    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 19610)

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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: 5799773933View full group profile
NameSpecialtyState
O T O L A R Y N G O L O G YPA
O T O L A R Y N G O L O G YPA
-PA
O T O L A R Y N G O L O G YPA

Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1396765186 — is the standard way to identify this listing.
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 Otolaryngology Physician. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Wyomissing, Pennsylvania as a primary anchor for Unknown Individual unless the record lists multiple sites.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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