Unknown Individual – Physician Assistant, NPI 1669447058

Unknown Individual is a healthcare provider. based in Sterling, Massachusetts. specializing in Physician Assistant. They hold a License No. 609 (MA). The NPI Number for Unknown Individual is 1669447058

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1669447058
Phone
Not provided
Address
121 JOHN DEE RD
Deactivation Date
11 October 2024
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

Provider Addresses for Unknown Individual

  • 121 JOHN DEE RD

    STERLING, MA 015642428

    Phone:

    Fax: (508) 334-1977

    Type: Mailing

  • PO Box 846028, Albany Street, Church Green, Financial District, Boston, Suffolk County, Massachusetts, 02284-6028, United States

    BOSTON, MA 022410001

    Phone: (800) 225-8885

    Fax: (508) 334-1977

    Type: Mailing

  • UMASS Memorial Medical Center University Campus Hospital, 55, Lake Avenue North, Worcester, Worcester County, Massachusetts, 01653, United States

    DEPARTMENT OF PEDIATRIC SURGERY

    WORCESTER, MA 016550002

    Phone: (508) 856-6889

    Fax: (508) 856-2043

    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 01564)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1669447058 — is the standard way to identify this listing.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Physician Assistant. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Sterling, Massachusetts in the data we show; additional addresses may exist on the full record.
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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