Unknown Individual – Optometrist, NPI 1750514568

Unknown Individual is a healthcare provider. based in Hialeah, Florida. specializing in OPTOMETRY. They hold a License No. 4430 (FL). The NPI Number for Unknown Individual is 1750514568

Main info

Organization
Inactive
17 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1750514568
Phone
(786) 251-5834
Address
3751 W 5TH AVE
Deactivation Date
29 April 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3056622990
Graduation Year
2009 (17 years ago)
PAC ID
0840321675
Group Practice PAC ID
2264695436
Professional Enrollment ID
I20100623000323
Address ID
FL331861304MI13852STXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

2,055 OPTOMETRY in FL

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Provider Addresses for Unknown Individual

  • 3751, West 5th Avenue, Hialeah Estates, Hialeah, Miami-Dade County, Florida, 33012, United States

    HIALEAH, FL 330124204

    Phone: (786) 251-5834

    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)

CMS reports 8 Open Payments records for all available years, with a total value of $717.

Total Amount is formed as General ($717) + Research ($0) + Ownership ($0) = $717.

Last reported payment date: 2024-01-26 • Largest payer in this snapshot: Johnson & Johnson Vision Care, Inc. ($208).

Total Amount

$717

General + Research + Ownership

Payments

8

Total payment records

General Amount

$717

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-01-26

Latest reported date

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.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-06-23

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
I20100623000323IOptometryFLTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33012)

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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: 2264695436View full group profile
NameSpecialtyState
O P T O M E T R YFL
O P T O M E T R YFL
O P T O M E T R YFL
O P T O M E T R YFL
O P T O M E T R YFL
O P T O M E T R YFL
O P T O M E T R YFL

Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1750514568.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Optometrist. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Hialeah, Florida. Check all listed addresses for suites or satellite offices.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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