Unknown Individual – Optometrist, NPI 1346251063

Unknown Individual is a healthcare provider. based in Pocatello, Idaho. specializing in Optometrist. They hold a License No. ODP680 (ID). The NPI Number for Unknown Individual is 1346251063

Main info

Organization
Inactive
44 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1346251063
Phone
(208) 233-1551
Address
475 YELLOWSTONE AVE
Deactivation Date
21 August 2024

Doctor Profile

Medical School Name
SOUTHERN CALIFORNIA COLLEGE OF OPTOMETRY
Secondary Phone
2082331551
Graduation Year
1982 (44 years ago)
PAC ID
1759456957
Professional Enrollment ID
I20080822000519
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

  • Yellowstone Avenue, Pocatello, Bannock County, Idaho, 83201, United States

    SUITE G

    POCATELLO, ID 832014528

    Phone: (208) 233-1551

    Fax: (208) 232-7896

    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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
92014Established patient complete exam of visual system5252$0
92250Photography of the retina3231$0
92004New patient complete exam of visual system1717$0
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Insurance plans in this area (ZIP 83201)

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Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1346251063 if you need a stable reference for Unknown Individual.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Optometrist. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Pocatello, Idaho for Unknown Individual based on available NPPES addresses.
How can I contact Unknown Individual?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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