Unknown Individual – Surgical Physician Assistant, NPI 1063672343

Unknown Individual is a healthcare provider. based in Green harbor, Massachusetts. specializing in Surgical Physician Assistant. They hold a License No. 28 (MA). The NPI Number for Unknown Individual is 1063672343

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1063672343
Phone
(781) 837-1357
Address
PO BOX 149
Deactivation Date
15 November 2024
Data current as of
20 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

  • PO BOX 149

    52 SHIRLEY ST

    GREEN HARBOR, MA 02041

    Phone: (781) 837-1357

    Type: Mailing

  • South Shore Hospital, 55, Fogg Road, South Weymouth, Weymouth, Norfolk County, Massachusetts, 02190, United States

    SOUTH SHORE HOSPITAL

    WEYMOUTH, MA 021902432

    Phone: (781) 340-8796

    Type: Location

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.

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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.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

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No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02041)

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Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1063672343 on file in the registry.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Surgical Physician Assistant. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Green Harbor, Massachusetts.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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