Unknown Individual – Optometrist, NPI 1013905488

Unknown Individual is a healthcare provider. based in Chandler, Arizona. specializing in Optometrist. They hold a License No. 874 (AZ). The NPI Number for Unknown Individual is 1013905488

Main info

Organization
Inactive
49 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1013905488
Phone
(480) 961-1865
Address
220 N MCKEMY AVE
Deactivation Date
22 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6027888413
Graduation Year
1977 (49 years ago)
PAC ID
2163418666
Group Practice PAC ID
6901033075
Professional Enrollment ID
I20040421000909
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

  • 220, North McKemy Avenue, Prado del Sol, Chandler, Maricopa County, Arizona, 85226, United States

    CHANDLER, AZ 852262654

    Phone: (480) 961-1865

    Fax: (480) 961-4605

    Type: Mailing

  • Batteries Plus Bulbs, 3415, West Glendale Avenue, Alhambra, Phoenix, Maricopa County, Arizona, 85051, United States

    BUILDING B, SUITE 11

    PHOENIX, AZ 850518386

    Phone: (602) 973-5868

    Fax: (602) 973-6076

    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 85226)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6901033075View full group profile

Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1013905488.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Optometrist in this dataset. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Chandler, Arizona 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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