Unknown Individual – Internal Medicine Physician, NPI 1881648418

Unknown Individual is a healthcare provider. based in Berlin, Vermont. specializing in Internal Medicine Physician. They hold a License No. 042.0004847 (VT). The NPI Number for Unknown Individual is 1881648418

Main info

Organization
Inactive
55 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1881648418
Phone
(802) 229-0010
Address
286 HOSPITAL LOOP
Deactivation Date
16 April 2026

Doctor Profile

Medical School Name
HARVARD MEDICAL SCHOOL
Secondary Phone
8022290010
Graduation Year
1971 (55 years ago)
PAC ID
0042345639
Professional Enrollment ID
I20100322000437
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

  • 286, Hospital Loop, Berlin, Washington County, Vermont, 05602, United States

    SUITE 5

    BERLIN, VT 056029523

    Phone: (802) 229-0010

    Fax: (802) 229-4867

    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.

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100322000437IInternal MedicineVTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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 05602)

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Provider's Procedures

Unknown Individual performs procedures in Internal Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
INTERNAL MEDICINEVT93010Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report956679

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 1881648418.
Is Unknown Individual still active if the NPI shows inactive?
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 Internal Medicine Physician in the directory — Clinical services aligned with this taxonomy classification.
Where in Vermont is Unknown Individual registered?
Use Berlin, Vermont as the headline location for Unknown Individual here.
Does Unknown Individual accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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