Unknown Individual – Orthopaedic Surgery Physician, NPI 1063459261

Unknown Individual is a healthcare provider. based in Brighton, Massachusetts. specializing in Orthopaedic Surgery Physician. They hold a License No. 30049 (MA). The NPI Number for Unknown Individual is 1063459261

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1063459261
Phone
(617) 787-2308
Address
11 NEVINS ST-SUITE 303
Deactivation Date
20 November 2025
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

  • 11 NEVINS ST-SUITE 303

    ST ELIZABETH'S MED BLDG

    BRIGHTON, MA 02135

    Phone: (617) 787-2308

    Type: Mailing

  • 11 NEVINS ST. SUITE 303

    ST. ELIZABETH'S MED BLG

    BRIGHTON, MA 02135

    Phone: (617) 787-2308

    Type: Location

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 $164.

Total Amount is formed as General ($164) + Research ($0) + Ownership ($0) = $164.

Last reported payment date: 2023-03-30 • Largest payer in this snapshot: Kairos Surgical Inc ($164).

Total Amount

$164

General + Research + Ownership

Payments

1

Total payment records

General Amount

$164

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-03-30

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Kairos Surgical Inc$164
View all Open Payments →|Open Payments Risk Radar →

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 02135)

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Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1063459261 for Unknown Individual, then check state licensing separately.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Orthopaedic Surgery Physician. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Brighton, Massachusetts may find Unknown Individual in results; validate coverage separately.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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