Unknown Individual – Psychiatry Physician, NPI 1679534408

Unknown Individual is a healthcare provider. based in Johnstown, Pennsylvania. specializing in Psychiatry Physician. They hold a License No. OS008084L (PA). The NPI Number for Unknown Individual is 1679534408

Main info

Organization
Inactive
38 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1679534408
Phone
(814) 535-8885
Address
1086 FRANKLIN ST
Deactivation Date
15 November 2023

Doctor Profile

Medical School Name
PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
-
Graduation Year
1988 (38 years ago)
PAC ID
6507891280
Professional Enrollment ID
I20050930000622
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

    JOHNSTOWN, PA 159054305

    Phone: (814) 535-8885

    Fax: (814) 535-8720

    Type: Mailing

  • 320, Main Street, Prospect Homes, Kernville, Conemaugh, Johnstown, Cambria County, Pennsylvania, 15901, United States

    JOHNSTOWN, PA 159011601

    Phone: (814) 534-1095

    Fax: (814) 534-6145

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $108.

Total Amount is formed as General ($108) + Research ($0) + Ownership ($0) = $108.

Last reported payment date: 2023-04-27 • Largest payer in this snapshot: Novo Nordisk Inc ($108).

Total Amount

$108

General + Research + Ownership

Payments

1

Total payment records

General Amount

$108

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-04-27

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Novo Nordisk Inc$108
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.

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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Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1679534408 — the number used across U.S. healthcare to identify this provider.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Johnstown?
Unknown Individual currently maps to Johnstown, Pennsylvania in this extract.
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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