Unknown Individual – Internal Medicine Physician, NPI 1083622922

Unknown Individual is a healthcare provider. based in East providence, Rhode Island. specializing in Internal Medicine Physician. They hold a License No. MD07466 (RI). The NPI Number for Unknown Individual is 1083622922

Main info

Organization
Inactive
40 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1083622922
Phone
(401) 435-3325
Address
ONE OFFICE PARKWAY
Deactivation Date
15 November 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4014562000
Graduation Year
1986 (40 years ago)
PAC ID
1456395433
Group Practice PAC ID
0547492696
Professional Enrollment ID
I20060411000791
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Office Parkway, Carpenters Corner, East Providence, Providence County, Rhode Island, 02914, United States

    EAST PROVIDENCE, RI 02914

    Phone: (401) 435-3325

    Fax: (401) 435-3327

    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 02914)

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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: 0547492696View full group profile
NameSpecialtyState
Medical Oncology, Internal MedicineRI
Interventional Cardiology, Cardiovascular Disease (Cardiology)RI
Cardiovascular Disease (Cardiology), Interventional CardiologyRI
Thoracic SurgeryRI
Mental Health CounselorRI
Orthopedic SurgeryRI
Mental Health CounselorRI
H E M A T O L O G Y/ O N C O L O G YRI
Physician AssistantRI
Nurse PractitionerRI

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 1083622922.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is East Providence, Rhode Island in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.