Unknown Individual – Ophthalmology Physician, NPI 1083663314

Unknown Individual is a healthcare provider. based in Lansing, Michigan. specializing in OPHTHALMOLOGY. They hold a License No. 4301076189 (MI). The NPI Number for Unknown Individual is 1083663314

Main info

Organization
Inactive
26 Years Of Experience
Name
Unknown Individual
NPI
1083663314
Phone
(517) 372-7987
Address
405 W GREENLAWN AVE STE 335
Deactivation Date
13 November 2025

Doctor Profile

Medical School Name
WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
2000 (26 years ago)
PAC ID
1153309109
Professional Enrollment ID
I20040708000032
Address ID
MI489102889LA405XXAVEX400
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

844 OPHTHALMOLOGY in MI

Provider Addresses for Unknown Individual

  • 405 W GREENLAWN AVE STE 335

    LANSING, MI 489102889

    Phone: (517) 372-7987

    Fax: (517) 372-7988

    Type: Mailing

  • 3960 PATIENT CARE DR STE 101

    LANSING, MI 489114276

    Phone: (517) 372-7987

    Fax: (517) 372-7988

    Type: Mailing

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 system240233$0
99213Established patient office or other outpatient visit, 20-29 minutes11498$0
92083Exam of visual field with extended testing11499$0
92134Imaging of retina8683$0
92133Imaging of optic nerve8584$0
View full utilization report →

Insurance plans in this area (ZIP 48910)

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Provider's Procedures

Unknown Individual performs procedures in OPHTHALMOLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OPHTHALMOLOGYMI92012Eye and medical examination for diagnosis and treatment, established patient5252

Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1083663314.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Ophthalmology Physician. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Lansing, Michigan for Unknown Individual; download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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