Unknown Individual – Medical Physician Assistant, NPI 1578073144

Unknown Individual is a healthcare provider. based in Bethlehem, Pennsylvania. specializing in Medical Physician Assistant. They hold a License No. MA059288 (PA). The NPI Number for Unknown Individual is 1578073144

Main info

Organization
Inactive
9 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1578073144
Phone
(484) 526-7800
Address
1469 8TH AVE
Deactivation Date
22 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9739267905
Graduation Year
2017 (9 years ago)
PAC ID
1557627015
Group Practice PAC ID
9032176516
Professional Enrollment ID
I20180918002267
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • St. Luke's Heart and Vascular Center, 1469, 8th Avenue, Allen Junction, Bethlehem, Lehigh County, Pennsylvania, 18018, United States

    BETHLEHEM, PA 180182256

    Phone: (484) 526-7800

    Fax: (484) 526-7810

    Type: Mailing

  • 1 DIAMOND HILL RD

    BERKELEY HEIGHTS, NJ 079222104

    Phone: (908) 273-4300

    Type: Mailing

  • 62 S FULLERTON AVE

    MONTCLAIR, NJ 070422676

    Phone: (973) 746-8585

    Fax: (973) 746-0088

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 4 Open Payments records for all available years, with a total value of $175.

Total Amount is formed as General ($175) + Research ($0) + Ownership ($0) = $175.

Last reported payment date: 2024-09-18 • Largest payer in this snapshot: Boston Scientific Corporation ($135).

Total Amount

$175

General + Research + Ownership

Payments

4

Total payment records

General Amount

$175

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-18

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes9177$0
36415Insertion of needle into vein for collection of blood sample5942$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes3216$0
80048Blood test, basic group of blood chemicals (calcium, total)2719$0
80061Blood test, lipids (cholesterol and triglycerides)2222$0
View full utilization report →

Insurance plans in this area (ZIP 18018)

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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: 9032176516View full group profile

Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1578073144.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's primary classification?
Medical Physician Assistant is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Bethlehem, Pennsylvania in our summary view.
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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