Unknown Individual – Cardiovascular Disease Physician, NPI 1700927084

Unknown Individual is a healthcare provider. based in Plains, Pennsylvania. specializing in Cardiovascular Disease Physician. They hold a License No. MD029559E (PA). The NPI Number for Unknown Individual is 1700927084

Main info

Organization
Inactive
44 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1700927084
Phone
(570) 823-1111
Address
667 N RIVER ST
Deactivation Date
23 October 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5702885441
Graduation Year
1982 (44 years ago)
PAC ID
6709067747
Group Practice PAC ID
7113914045
Professional Enrollment ID
I20110223000993
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

Provider Addresses for Unknown Individual

  • 667 N RIVER ST

    SUITE 201

    PLAINS, PA 187051013

    Phone: (570) 823-1111

    Fax: (570) 824-9044

    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 18705)

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Provider's Procedures

Unknown Individual performs procedures in Cardiovascular Disease Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
CARDIOVASCULAR DISEASE (CARDIOLOGY)PA78452Nuclear medicine study of vessels of heart using drugs or exercise multiple studies239239

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: 7113914045View full group profile

Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1700927084.
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 Cardiovascular Disease Physician in the directory — Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Plains?
Public fields place Unknown Individual around Plains, 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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