Unknown Individual – Family Medicine Physician, NPI 1114909082

Unknown Individual is a healthcare provider. based in Boston, Massachusetts. specializing in Family Medicine Physician. They hold a License No. 57676 (MA). The NPI Number for Unknown Individual is 1114909082

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1114909082
Phone
(800) 225-8885
Address
PO BOX 415348
Deactivation Date
26 June 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • PO Box 846028, Albany Street, Church Green, Financial District, Boston, Suffolk County, Massachusetts, 02284-6028, United States

    BOSTON, MA 022415348

    Phone: (800) 225-8885

    Fax: (508) 334-1977

    Type: Mailing

  • UMASS Memorial Medical Center University Campus Hospital, 55, Lake Avenue North, Worcester, Worcester County, Massachusetts, 01653, United States

    PEDIATRIC EMERGENCY MEDICINE

    WORCESTER, MA 016550002

    Phone: (774) 442-2599

    Fax: (774) 442-2510

    Type: Location

  • 181 FAIRFIELD DRIVE

    NORTH KINGSTON, RI 02852

    Phone: (800) 225-8885

    Fax: (508) 334-1977

    Type: Mailing

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 ·

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 02241)

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Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1114909082 in the public NPI dataset.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual's primary classification?
Family Medicine Physician is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Boston, Massachusetts in the data we show; additional addresses may exist on the full record.
Why does Unknown Individual have multiple addresses?
4 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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