Unknown Individual – Pain Medicine (Anesthesiology) Physician, NPI 1629073069

Pain Medicine (Anesthesiology) Physician

Unknown Individual is a healthcare provider. based in Johnstown, Pennsylvania. specializing in Pain Medicine (Anesthesiology) Physician. They hold a License No. MD040760E (PA). The NPI Number for Unknown Individual is 1629073069

Main info

Organization

Inactive

40 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1629073069

Phone

(814) 534-5138

Address

1086 FRANKLIN ST

Deactivation Date

10 May 2023

Doctor Profile

Medical School Name

HAHNEMANN UNIVERSITY COLLEGE OF MEDICINE

Secondary Phone

8145347560

Graduation Year

1986 (40 years ago)

PAC ID

6002898806

Group Practice PAC ID

1557360369

Professional Enrollment ID

I20041006000771

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

Conemaugh Memorial Medical Center, 1086, Franklin Street, Johnstown, Cambria County, Pennsylvania, 15905, United States
STE A401
JOHNSTOWN, PA 159054305
Phone: (814) 534-5138
Fax: (814) 534-5149
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 15905)

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Provider's Procedures

Unknown Individual performs procedures in Pain Medicine (Anesthesiology) Physician. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
ANESTHESIOLOGY	PA	01402	Anesthesia for open or endoscopic total knee joint replacement	12	12

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: 1557360369View full group profile

Name	Specialty	State
VICTORIA EMEIGH (CRNA)	-	PA

Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?

Yes — Unknown Individual has NPI 1629073069 on file in the registry.

Does inactive status mean Unknown Individual stopped practicing?

Inactive registry status can reflect deactivation, consolidation, or data lag.

What kind of doctor is Unknown Individual?

Unknown Individual is associated with Pain Medicine (Anesthesiology) Physician in the directory — Clinical services aligned with this taxonomy classification.

Is Unknown Individual located near Johnstown?

Unknown Individual currently maps to Johnstown, Pennsylvania in this extract.

What does 2 location(s) imply?

2 practice locations appear in the available data.