Unknown Individual – Neurological Surgery Physician, NPI 1366431579

Unknown Individual is a healthcare provider. based in Boston, Massachusetts. specializing in Neurological Surgery Physician. They hold a License No. 53886 (MA). The NPI Number for Unknown Individual is 1366431579

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1366431579
Phone
(617) 414-5405
Address
850 HARRISON AVENUE
Deactivation Date
15 May 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

  • 850, Harrison Avenue, South End, Boston, Suffolk County, Massachusetts, 02118, United States

    YACC-BNC7

    BOSTON, MA 021184001

    Phone: (617) 414-5405

    Fax: (617) 414-6031

    Type: Mailing

  • Shapiro Center, 725, Albany Street, South End, Boston, Suffolk County, Massachusetts, 02118, United States

    SHAPIRO 7, SUITE C

    BOSTON, MA 02118

    Phone: (617) 638-8992

    Fax: (617) 638-8979

    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.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

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

Insurance plans in this area (ZIP 02118)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1366431579 — is the standard way to identify this listing.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's primary classification?
Neurological Surgery 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.
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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