Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1174586309

Unknown Individual is a healthcare provider. based in Westwood, Massachusetts. specializing in Certified Registered Nurse Anesthetist. They hold a License No. 79968 (MA). The NPI Number for Unknown Individual is 1174586309

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1174586309
Phone
(781) 407-7713
Address
690 CANTON ST
Deactivation Date
23 May 2022
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

  • Beth Israel Deaconess Hospital - Plymouth, 275, Sandwich Street, Jabez Corner, Plymouth, Plymouth County, Massachusetts, 02360, United States

    PLYMOUTH, MA 023602183

    Phone: (508) 830-2113

    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.

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

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1174586309 in the public NPI dataset.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Certified Registered Nurse Anesthetist. 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.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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