Unknown Individual – Ophthalmology Physician, NPI 1578688305

Unknown Individual is a healthcare provider. based in Pinellas park, Florida. specializing in OPHTHALMOLOGY. They hold a License No. OS1513 (FL). The NPI Number for Unknown Individual is 1578688305

Main info

Organization
Inactive
64 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1578688305
Phone
(727) 544-2850
Address
7995 66TH ST
Deactivation Date
30 April 2026

Doctor Profile

Medical School Name
AT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Secondary Phone
7275442850
Graduation Year
1962 (64 years ago)
PAC ID
8820196132
Professional Enrollment ID
I20070611000502
Address ID
FL337812163PI7995XNXXX402
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

1,548 OPHTHALMOLOGY in FL

Provider Addresses for Unknown Individual

  • 7995 66TH ST

    SUITE C

    PINELLAS PARK, FL 337812163

    Phone: (727) 544-2850

    Fax: (727) 544-5044

    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.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-06-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20070611000502IOphthalmologyFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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
92020Exam of the internal drainage system of eye40635$0
92202Extended exam of the back part of the eye with optic nerve drawing38537$0
99213Established patient office or other outpatient visit, 20-29 minutes37035$0
68801Dilation of tear drainage opening32327$0
92285Photography of content of eyes2114$0
View full utilization report →

Insurance plans in this area (ZIP 33781)

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Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1578688305.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Ophthalmology Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Pinellas Park, Florida?
If you are local to Pinellas Park, Florida, Unknown Individual may be relevant to your search.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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