Unknown Individual – Optometrist, NPI 1336245745

Unknown Individual is a healthcare provider. based in Bangor, Maine. specializing in Optometrist. They hold a License No. OPT747 (ME). The NPI Number for Unknown Individual is 1336245745

Main info

Organization
Inactive
39 Years Of Experience
Name
Unknown Individual
NPI
1336245745
Phone
(207) 947-2385
Address
11 BANGOR MALL BOULEVARD
Deactivation Date
6 March 2025

Doctor Profile

Medical School Name
NEW ENGLAND COLLEGE OF OPTOMETRY
Secondary Phone
2076223015
Graduation Year
1987 (39 years ago)
PAC ID
5294636932
Group Practice PAC ID
5890037568
Professional Enrollment ID
I20050518000692
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

  • Advanced Clinical Eye Care, 11, Bangor Mall Boulevard, Bangor, Penobscot County, Maine, 04401, United States

    BANGOR, ME 04401

    Phone: (207) 947-2385

    Fax: (207) 947-2430

    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
92250Photography of the retina515509$0
92082Exam of visual field with intermediate testing507502$0
92014Established patient complete exam of visual system324311$0
92004New patient complete exam of visual system212212$0
99214Established patient office or other outpatient visit, 30-39 minutes2523$0
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Insurance plans in this area (ZIP 04401)

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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: 5890037568View full group profile
NameSpecialtyState
-NY

Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1336245745.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Optometrist in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Bangor, Maine in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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