Unknown Individual – Optometrist, NPI 1073576013

Unknown Individual is a healthcare provider. based in Fort myers, Florida. specializing in Optometrist. They hold a License No. OPC4019 (FL). The NPI Number for Unknown Individual is 1073576013

Main info

Organization
Inactive
26 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1073576013
Phone
(239) 939-3456
Address
4101 EVANS AVE
Deactivation Date
30 October 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2399393456
Graduation Year
2000 (26 years ago)
PAC ID
0143247692
Group Practice PAC ID
0749187847
Professional Enrollment ID
I20051025000299
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

Loading map...

Provider Addresses for Unknown Individual

  • 4101, Evans Avenue, Fort Myers, Lee County, Florida, 33901, United States

    FORT MYERS, FL 33901

    Phone: (239) 939-3456

    Fax: (239) 790-2432

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

CMS reports 9 Open Payments records for all available years, with a total value of $611.

Total Amount is formed as General ($611) + Research ($0) + Ownership ($0) = $611.

Last reported payment date: 2024-06-26 • Largest payer in this snapshot: Bausch & Lomb Americas Inc. ($240).

Total Amount

$611

General + Research + Ownership

Payments

9

Total payment records

General Amount

$611

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-06-26

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
92014Established patient complete exam of visual system549506$0
92134Imaging of retina512481$0
99213Established patient office or other outpatient visit, 20-29 minutes253162$0
92133Imaging of optic nerve143112$0
92004New patient complete exam of visual system137137$0
View full utilization report →

Insurance plans in this area (ZIP 33901)

Loading plans...

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
OPTOMETRYFL92012Eye and medical examination for diagnosis and treatment, established patient195170
OPTOMETRYFL92083Measurement of field of vision during daylight conditions3131
OPTOMETRYFL92134Diagnostic imaging of retina6867

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: 0749187847View full group profile

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1073576013 is assigned to Unknown Individual under the national enumeration system.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Optometrist. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Fort Myers, Florida for Unknown Individual; download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

Similar Providers

5995 S POINTE BLVD
NPI: 1629074067
5995 S POINTE BLVD
NPI: 1073519153
21275, Olean Boulevard, Port Charlotte, Charlotte County, Florida, 33952, United States
NPI: 1104824473
12731 NEW BRITTANY BLVD
NPI: 1700884525
11160 LAKELAND CIR
NPI: 1538160197
PO BOX 61199
NPI: 1528069903
12731 NEW BRITTANY BLVD
NPI: 1710989603
1360, East Venice Avenue, Eastgate, Venice, Sarasota County, Florida, 34285, United States
NPI: 1679575187