Unknown Individual – Diagnostic Radiology Physician, NPI 1417909367

Unknown Individual is a healthcare provider. based in Danville, Pennsylvania. specializing in Diagnostic Radiology Physician. They hold a License No. MD044572E (PA). The NPI Number for Unknown Individual is 1417909367

Main info

Organization
Inactive
39 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1417909367
Phone
(570) 271-6144
Address
100 N ACADEMY AVE
Deactivation Date
15 January 2026

Doctor Profile

Medical School Name
PERELMAN SCHOOL OF MED AT THE UNIVERSITY OF PENNSYLVANIA
Secondary Phone
5703212500
Graduation Year
1987 (39 years ago)
PAC ID
8022906148
Group Practice PAC ID
3870482409
Professional Enrollment ID
I20040309000966
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

  • Geisinger Medical Center Danville, 100, North Academy Avenue, Danville, Montour County, Pennsylvania, 17822, United States

    DANVILLE, PA 178223034

    Phone: (570) 271-6144

    Fax: (570) 271-6578

    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 17822)

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Provider's Procedures

Unknown Individual performs procedures in Diagnostic Radiology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DIAGNOSTIC RADIOLOGYPA71010X-ray of chest, 1 view, front334281
DIAGNOSTIC RADIOLOGYPA71250CT scan chest5252
DIAGNOSTIC RADIOLOGYPA74177CT scan of abdomen and pelvis with contrast1717

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: 3870482409View full group profile
NameSpecialtyState
Diagnostic RadiologyPA
Diagnostic RadiologyFL
Diagnostic RadiologyPA
Diagnostic RadiologyPA
Diagnostic RadiologyMN
Diagnostic RadiologyMD
Diagnostic RadiologyPA
Diagnostic RadiologyNY
-OH

Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1417909367; it appears in the national provider directory.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Diagnostic Radiology Physician. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Danville, Pennsylvania for Unknown Individual based on available NPPES addresses.
What if Danville, Pennsylvania seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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