Unknown Individual – Sports Medicine (Neuromusculoskeletal Medicine) Physician, NPI 1407876733

Unknown Individual is a healthcare provider. based in Suffield, Connecticut. specializing in Sports Medicine (Neuromusculoskeletal Medicine) Physician. They hold a License No. 000533 (CT). The NPI Number for Unknown Individual is 1407876733

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1407876733
Phone
(860) 668-4767
Address
230B MOUNTAIN RD
Deactivation Date
1 January 2026
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

  • 230, Mountain Road, Suffield Historic District, West Suffield, Suffield, Hartford County, Connecticut, 06078, United States

    SUFFIELD, CT 060782094

    Phone: (860) 668-4767

    Fax: (860) 668-6600

    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)

CMS reports 1 Open Payments records for all available years, with a total value of $161.

Total Amount is formed as General ($161) + Research ($0) + Ownership ($0) = $161.

Last reported payment date: 2023-01-11 • Largest payer in this snapshot: Integra LifeSciences Corporation ($161).

Total Amount

$161

General + Research + Ownership

Payments

1

Total payment records

General Amount

$161

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-01-11

Latest reported date

Top Companies

Largest payers in this snapshot

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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 06078)

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Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1407876733 — the number used across U.S. healthcare to identify this provider.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Sports Medicine (Neuromusculoskeletal Medicine) Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Suffield, Connecticut.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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