Unknown Individual – Internal Medicine Physician, NPI 1336142777

Unknown Individual is a healthcare provider. based in Reston, Virginia. specializing in Internal Medicine Physician. They hold a License No. 0101033182 (VA). The NPI Number for Unknown Individual is 1336142777

Main info

Organization
Inactive
48 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1336142777
Phone
(703) 471-5340
Address
1800 TOWN CENTER DR
Deactivation Date
26 March 2026

Doctor Profile

Medical School Name
EASTERN VIRGINIA MEDICAL SCHOOL
Secondary Phone
7034715340
Graduation Year
1978 (48 years ago)
PAC ID
2365501202
Professional Enrollment ID
I20081106000304

Contacts

Secure Messaging
dennis.sager.1@16718.direct.athenahealth.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness85
Years active:0State licenses:1Other namesUpdated within 12 months

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Provider Addresses for Unknown Individual

  • Town Center Drive, Reston, Virginia, 20190, United States

    STE 313

    RESTON, VA 201903200

    Phone: (703) 471-5340

    Fax: (703) 437-6177

    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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99215Established patient office or other outpatient visit, 40-54 minutes10460$0
36415Insertion of needle into vein for collection of blood sample9665$0
99214Established patient office or other outpatient visit, 30-39 minutes9259$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit6969$0
99213Established patient office or other outpatient visit, 20-29 minutes6449$0
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Insurance plans in this area (ZIP 20190)

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Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1336142777 as the unique 10-digit identifier.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
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.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Reston, Virginia.
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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