Unknown Individual – Ophthalmology Physician, NPI 1073514881

Ophthalmology Physician

Unknown Individual is a healthcare provider. based in Decatur, Georgia. specializing in Ophthalmology Physician. They hold a License No. 010433 (GA). The NPI Number for Unknown Individual is 1073514881

Main info

Organization

Inactive

66 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1073514881

Phone

(404) 292-2500

Address

PO BOX 1798

Deactivation Date

20 September 2023

Doctor Profile

Medical School Name

TULANE UNIVERSITY SCHOOL OF MEDICINE

Secondary Phone

4042922500

Graduation Year

1960 (66 years ago)

PAC ID

7315005816

Group Practice PAC ID

7214923069

Professional Enrollment ID

I20081028000570

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

Druid Hills High School, 1798, Haygood Drive Northeast, Emory Estates, Atlanta, DeKalb County, Georgia, 30307, United States
DECATUR, GA 300311798
Phone: (404) 292-2500
Fax: (404) 294-9361
Type: Mailing
1457, Scott Boulevard, Scottdale, DeKalb County, Georgia, 30030, United States
DECATUR, GA 30030
Phone: (404) 292-2500
Fax: (404) 294-9361
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 30031)

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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: 7214923069View full group profile

Name	Specialty	State
DR. PAUL EMMET MCMANUS (M.D.)	-	GA
DR. INDIRA GM MENON (M.D.)	O P H T H A L M O L O G Y	GA
DR. AJEET DHINGRA (M.D.)	O P H T H A L M O L O G Y	GA
DR. LAURA ALISON BEALER (M.D.)	O P H T H A L M O L O G Y	GA
SHALIN S SHAH (M.D.)	O P H T H A L M O L O G Y	GA
POOJA SHAILESH PATEL (OD)	O P T O M E T R Y	GA
RONAK PATEL (M.D.)	O P H T H A L M O L O G Y	IN
DR. JOHN WILLIAM THOMAS (M.D.)	O P H T H A L M O L O G Y	GA

Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?

You can confirm Unknown Individual with NPI 1073514881; it appears in the national provider directory.

How do I interpret inactive records for Unknown Individual?

Treat inactive as a signal to verify Unknown Individual through official channels.

What field does Unknown Individual work in?

You can think of Unknown Individual as practicing within Ophthalmology Physician. Clinical services aligned with this taxonomy classification.

What location shows for Unknown Individual?

We surface Decatur, Georgia for Unknown Individual based on available NPPES addresses.

What if Decatur, Georgia seems incomplete?

Street-level detail can be omitted — open the full address list for this NPI.

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