Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1164409207

Unknown Individual is a healthcare provider. based in Westwood, Massachusetts. specializing in Certified Registered Nurse Anesthetist. They hold a License No. 21728 (RI). The NPI Number for Unknown Individual is 1164409207

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1164409207
Phone
(781) 407-7713
Address
690 CANTON ST
Deactivation Date
25 December 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

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Provider Addresses for Unknown Individual

  • 690, Canton Street, Westwood, Norfolk County, Massachusetts, 02090, United States

    SUITE 325

    WESTWOOD, MA 020902321

    Phone: (781) 407-7713

    Fax: (781) 407-0998

    Type: Mailing

  • Kent Hospital, 455, Toll Gate Road, Apponaug Historic District, Apponaug, Warwick, Kent County, Rhode Island, 02886, United States

    WARWICK, RI 028862759

    Phone: (401) 738-1516

    Fax: (401) 738-8837

    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.

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 02090)

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Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1164409207.
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 Certified Registered Nurse Anesthetist in this dataset. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Westwood, Massachusetts may find Unknown Individual in results; validate coverage separately.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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