Unknown Individual – Pediatric Optometrist, NPI 1255326690

Unknown Individual is a healthcare provider. based in Wichita, Kansas. specializing in Pediatric Optometrist. They hold a License No. 1091-2 (KS). The NPI Number for Unknown Individual is 1255326690

Main info

Organization
Inactive
50 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1255326690
Phone
(316) 683-8204
Address
8118 E DOUGLAS AVE
Deactivation Date
22 June 2021

Doctor Profile

Medical School Name
ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Secondary Phone
-
Graduation Year
1976 (50 years ago)
PAC ID
6406971787
Professional Enrollment ID
I20100909000694
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 8118, East Douglas Avenue, Forest Hills, Wichita, Sedgwick County, Kansas, 67206, United States

    SUITE 107

    WICHITA, KS 672062364

    Phone: (316) 683-8204

    Fax: (316) 683-8204

    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.

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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 67206)

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Provider's Procedures

Unknown Individual performs procedures in Pediatric Optometrist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OPTOMETRYKS92012Eye and medical examination for diagnosis and treatment, established patient140140

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1255326690 is assigned to Unknown Individual under the national enumeration system.
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 Pediatric Optometrist. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Wichita, Kansas for Unknown Individual; expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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