Unknown Individual – Ophthalmology Physician, NPI 1679574263

Unknown Individual is a healthcare provider. based in Springfield, Massachusetts. specializing in Ophthalmology Physician. They hold a License No. 59174 (MA). The NPI Number for Unknown Individual is 1679574263

Main info

Organization
Inactive
46 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1679574263
Phone
(413) 736-7900
Address
780 CHESTNUT ST
Deactivation Date
12 April 2022

Doctor Profile

Medical School Name
NEW YORK UNIVERSITY MEDICAL COLLEGE - NLG
Secondary Phone
-
Graduation Year
1980 (46 years ago)
PAC ID
8729035415
Professional Enrollment ID
I20050405000715
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

  • 780, Chestnut Street, Springfield, Hampden County, Massachusetts, 01199, United States

    SUITE 19

    SPRINGFIELD, MA 011071610

    Phone: (413) 736-7900

    Fax: (413) 736-2048

    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 01107)

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Provider's Procedures

Unknown Individual performs procedures in Ophthalmology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OPHTHALMOLOGYMA92012Eye and medical examination for diagnosis and treatment, established patient379283

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1679574263 — is the standard way to identify this listing.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Ophthalmology Physician. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Springfield, Massachusetts as a primary anchor for Unknown Individual unless the record lists multiple sites.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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