Unknown Individual – Urology Physician, NPI 1487654877

Unknown Individual is a healthcare provider. based in Wyomissing, Pennsylvania. specializing in Urology Physician. They hold a License No. MD043613L (PA). The NPI Number for Unknown Individual is 1487654877

Main info

Organization
Inactive
38 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1487654877
Phone
(610) 372-8995
Address
1320 BROADCASTING RD
Deactivation Date
25 August 2021

Doctor Profile

Medical School Name
JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
6103728995
Graduation Year
1988 (38 years ago)
PAC ID
2961573274
Group Practice PAC ID
9931001559
Professional Enrollment ID
I20100113000588
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

  • Broadcasting Road, wyomissing hills, Whitfield, Spring Township, Berks County, Pennsylvania, 19609, United States

    STE 200

    WYOMISSING, PA 196103222

    Phone: (610) 372-8995

    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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Provider's Procedures

Unknown Individual performs procedures in Urology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
UROLOGYPA76872Ultrasound of rectum4242
UROLOGYPA81002Urinalysis, manual test538389

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: 9931001559View full group profile

Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1487654877.
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 is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Urology Physician. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Wyomissing, Pennsylvania in the data we show; additional addresses may exist on the full record.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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