Unknown Individual – Ophthalmology Physician, NPI 1164417192

Unknown Individual is a healthcare provider. based in Fraser, Michigan. specializing in Ophthalmology Physician. They hold a License No. 4301046782 (MI). The NPI Number for Unknown Individual is 1164417192

Main info

Organization
Inactive
49 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1164417192
Phone
(586) 296-7250
Address
PO BOX 26010
Deactivation Date
17 January 2024

Doctor Profile

Medical School Name
NEW YORK MEDICAL COLLEGE
Secondary Phone
5862967250
Graduation Year
1977 (49 years ago)
PAC ID
1355445263
Group Practice PAC ID
1254611809
Professional Enrollment ID
I20070403000289

Contacts

Secure Messaging
jschartenberg@frasereye.direct.eyemdemr
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness85
Years active:0State licenses:1Other namesUpdated within 12 months

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Provider Addresses for Unknown Individual

  • PO BOX 26010

    FRASER, MI 480266010

    Phone: (586) 296-7250

    Fax: (586) 296-0276

    Type: Mailing

  • Fraser Eye, 33080, Utica Road, Fraser, Macomb County, Michigan, 48026, United States

    FRASER, MI 480262038

    Phone: (586) 296-7250

    Fax: (586) 296-0276

    Type: Location

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 system4545$0
99213Established patient office or other outpatient visit, 20-29 minutes1917$0
99214Established patient office or other outpatient visit, 30-39 minutes1414$0
92250Photography of the retina1212$0
92134Imaging of retina1111$0
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Insurance plans in this area (ZIP 48026)

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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: 1254611809View full group profile
NameSpecialtyState
O P H T H A L M O L O G YMI
O P H T H A L M O L O G YMI
O P T O M E T R YMI
O P H T H A L M O L O G YOH
O P H T H A L M O L O G YMI
O P H T H A L M O L O G YMI
O P H T H A L M O L O G YMI
O P H T H A L M O L O G YMI
O P H T H A L M O L O G YPA
O P H T H A L M O L O G YMI

Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1164417192 for Unknown Individual.
Does inactive mean outdated data for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
How should patients interpret Unknown Individual's specialty?
The extract shows Ophthalmology Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Fraser, Michigan in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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