Unknown Individual – Optometrist, NPI 1225489347

Unknown Individual is a healthcare provider. based in Coeur d alene, Idaho. specializing in Optometrist. They hold a License No. OD 60664944 (WA). The NPI Number for Unknown Individual is 1225489347

Main info

Organization
Inactive
10 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1225489347
Phone
(208) 667-1591
Address
1801 N 3RD ST
Deactivation Date
16 August 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5098937574
Graduation Year
2016 (10 years ago)
PAC ID
8325335771
Group Practice PAC ID
2163323841
Professional Enrollment ID
I20160928001712
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 1801 N 3RD ST

    COEUR D ALENE, ID 838143400

    Phone: (208) 667-1591

    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.

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 83814)

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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: 2163323841View full group profile
NameSpecialtyState
O P T O M E T R YWA
O P T O M E T R YWA

Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1225489347.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Optometrist. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Coeur D Alene, Idaho may find Unknown Individual in results; validate coverage separately.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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