Unknown Individual – Optometrist, NPI 1124056262

Unknown Individual is a healthcare provider. based in Birmingham, Alabama. specializing in Optometrist. They hold a License No. S-576-TA-128 (AL). The NPI Number for Unknown Individual is 1124056262

Main info

Organization
Inactive
41 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1124056262
Phone
(256) 737-9109
Address
530 CASTLEBRIDGE LN
Deactivation Date
18 July 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2056633937
Graduation Year
1985 (41 years ago)
PAC ID
4486661576
Group Practice PAC ID
9537414875
Professional Enrollment ID
I20060403000401
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

  • 530 CASTLEBRIDGE LN

    BIRMINGHAM, AL 35242

    Phone: (256) 737-9109

    Type: Mailing

  • 3429, Pelham Parkway, Blueberry Estates, Pelham, Shelby County, Alabama, 35124, United States

    PELHAM, AL 351242009

    Phone: (205) 663-3937

    Fax: (205) 663-3937

    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 35242)

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Provider's Procedures

Unknown Individual performs procedures in Optometrist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OPTOMETRYAL92083Measurement of field of vision during daylight conditions5638
OPTOMETRYAL92134Diagnostic imaging of retina3332

Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1124056262 for Unknown Individual.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Optometrist. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Birmingham, Alabama?
For routing, start with Birmingham, Alabama for Unknown Individual, then verify phone and hours locally.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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