Unknown Individual – Optometrist, NPI 1609815869

Unknown Individual is a healthcare provider. based in Boca raton, Florida. specializing in Optometrist. They hold a License No. OPC1641 (FL). The NPI Number for Unknown Individual is 1609815869

Main info

Organization
Inactive
49 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1609815869
Phone
(561) 852-5149
Address
8592 FLAMINGO DR
Deactivation Date
3 January 2024

Doctor Profile

Medical School Name
ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Secondary Phone
9543705883
Graduation Year
1977 (49 years ago)
PAC ID
5294738258
Group Practice PAC ID
7315196060
Professional Enrollment ID
I20060811000022
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

  • 8592 FLAMINGO DR

    BOCA RATON, FL 334965067

    Phone: (561) 852-5149

    Type: Mailing

  • 2551, South University Drive, Davie, Broward County, Florida, 33324, United States

    DAVIE, FL 333245845

    Phone: (954) 370-5883

    Fax: (954) 370-8799

    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 33496)

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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: 7315196060View full group profile

Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1609815869 — is the standard way to identify this listing.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Optometrist. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Boca Raton, Florida as a primary anchor for Unknown Individual unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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