Unknown Individual – Nephrology Physician, NPI 1639116809

Unknown Individual is a healthcare provider. based in Levittown, Pennsylvania. specializing in Nephrology Physician. They hold a License No. OS003724L (PA). The NPI Number for Unknown Individual is 1639116809

Main info

Organization
Inactive
50 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1639116809
Phone
(215) 741-3510
Address
PO BOX 538
Deactivation Date
10 July 2024

Doctor Profile

Medical School Name
PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
2157413510
Graduation Year
1976 (50 years ago)
PAC ID
4880662170
Group Practice PAC ID
4486632247
Professional Enrollment ID
I20110527000336
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

  • PO BOX 538

    LEVITTOWN, PA 190580538

    Phone: (215) 741-3510

    Fax: (215) 741-3519

    Type: Mailing

  • Town Center Drive, Langhorne Gardens, Middletown Township, Bucks County, Pennsylvania, 19047, United States

    SUITE 152

    LANGHORNE, PA 190473030

    Phone: (215) 741-3510

    Fax: (215) 741-3519

    Type: Location

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 19058)

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Provider's Procedures

Unknown Individual performs procedures in Nephrology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
NEPHROLOGYPA90935Hemodialysis procedure with one physician evaluation5438
NEPHROLOGYPA90961Dialysis services (2-3 physician visits per month), patient 20 years of age and older5034

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: 4486632247View full group profile

Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1639116809 as the unique 10-digit identifier.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Nephrology Physician in the directory — Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Levittown?
Public fields place Unknown Individual around Levittown, Pennsylvania. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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