Unknown Individual – Surgery Physician, NPI 1124031299

Unknown Individual is a healthcare provider. based in Concord, Massachusetts. specializing in Surgery Physician. They hold a License No. 29665 (MA). The NPI Number for Unknown Individual is 1124031299

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1124031299
Phone
(978) 369-5677
Address
290 BAKER AVE
Deactivation Date
1 January 2026
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

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Provider Addresses for Unknown Individual

  • Dermatology Associates, 290, N220, Baker Avenue, West Concord, Concord, Middlesex County, Massachusetts, 01742, United States

    CONCORD, MA 01742

    Phone: (978) 369-5677

    Fax: (978) 371-1673

    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.

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

Insurance plans in this area (ZIP 01742)

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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 1124031299 for Unknown Individual, then check state licensing separately.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Surgery Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Concord, Massachusetts as a primary anchor for Unknown Individual unless the record lists multiple sites.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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