Unknown Individual – Ophthalmology Physician, NPI 1609858554

Unknown Individual is a healthcare provider. based in Fort smith, Arkansas. specializing in Ophthalmology Physician. They hold a License No. C4990 (AR). The NPI Number for Unknown Individual is 1609858554

Main info

Organization
Inactive
51 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1609858554
Phone
(479) 646-3937
Address
5518 ELLSWORTH RD
Deactivation Date
31 January 2024

Doctor Profile

Medical School Name
UNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE
Secondary Phone
-
Graduation Year
1975 (51 years ago)
PAC ID
4284736992
Professional Enrollment ID
I20100907000159
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

  • Ellsworth Road, Fort Smith, Sebastian County, Arkansas, 72903, United States

    FORT SMITH, AR 729033222

    Phone: (479) 646-3937

    Fax: (479) 646-3605

    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.

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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 72903)

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Provider's Procedures

Unknown Individual performs procedures in Ophthalmology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OPHTHALMOLOGYAR92134Diagnostic imaging of retina18643

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 1609858554 for Unknown Individual.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Ophthalmology Physician. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Fort Smith, Arkansas?
For routing, start with Fort Smith, Arkansas for Unknown Individual, then verify phone and hours locally.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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