Unknown Individual – Nurse Practitioner, NPI 1205804762

Unknown Individual is a healthcare provider. based in Hyannis, Massachusetts. specializing in Nurse Practitioner. They hold a License No. 134161 (MA). The NPI Number for Unknown Individual is 1205804762

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1205804762
Phone
(508) 862-5560
Address
22 LEWIS BAY RD
Deactivation Date
30 October 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

  • 22, Lewis Bay Road, Hyannis, Barnstable, Barnstable County, Massachusetts, 02601, United States

    PRIMARY CARE INTERNISTS

    HYANNIS, MA 02601

    Phone: (508) 862-5560

    Fax: (508) 771-7321

    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 02601)

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Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1205804762.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What kind of provider is Unknown Individual?
The page reflects Nurse Practitioner for Unknown Individual. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Hyannis, Massachusetts for Unknown Individual based on available NPPES addresses.
What if Hyannis, Massachusetts seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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