Unknown Individual – Surgery Physician, NPI 1366430696

Unknown Individual is a healthcare provider. based in Elizabeth, New Jersey. specializing in Surgery Physician. They hold a License No. MA02282 (NJ). The NPI Number for Unknown Individual is 1366430696

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1366430696
Phone
(908) 355-3600
Address
240 WILLIAMSON ST
Deactivation Date
18 December 2020
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

  • 240, Williamson Street, Elizabeth, Union County, New Jersey, 07202, United States

    SUITE 302

    ELIZABETH, NJ 072023674

    Phone: (908) 355-3600

    Fax: (908) 355-9490

    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 07202)

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Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1366430696 is assigned to Unknown Individual under the national enumeration system.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What kind of provider is Unknown Individual?
The page reflects Surgery Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in New Jersey?
You will see Elizabeth, New Jersey on file for Unknown Individual alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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