Unknown Individual – Retina Specialist (Ophthalmology) Physician, NPI 1205863859

Retina Specialist (Ophthalmology) Physician

Unknown Individual is a healthcare provider. based in Novi, Michigan. specializing in Retina Specialist (Ophthalmology) Physician. They hold a License No. 4301044484 (MI). The NPI Number for Unknown Individual is 1205863859

Main info

Organization

Inactive

50 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1205863859

Phone

(248) 319-0161

Address

39650 ORCHARD HILL PL

Deactivation Date

12 December 2022

Doctor Profile

Medical School Name

GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE

Secondary Phone

2319380710

Graduation Year

1976 (50 years ago)

PAC ID

1557273059

Group Practice PAC ID

2264344746

Professional Enrollment ID

I20061004000310

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience19

Completeness75

Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

39650, Orchard Hill Place, Novi, Oakland County, Michigan, 48375, United States
200
NOVI, MI 483755391
Phone: (248) 319-0161
Fax: (248) 319-0168
Type: Mailing
3555, West 13 Mile Road, Royal Oak, Oakland County, Michigan, 48073, United States
LL-20
ROYAL OAK, MI 480736710
Phone: (248) 288-2269
Fax: (248) 288-2265
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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48375)

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Provider's Procedures

Unknown Individual performs procedures in Retina Specialist (Ophthalmology) Physician. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
OPHTHALMOLOGY	MI	92134	Diagnostic imaging of retina	728	287

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: 2264344746View full group profile

Name	Specialty	State
DR. PAUL VARASTAD RAPHAELIAN (MD)	O P H T H A L M O L O G Y	MI
DR. DOUGLAS J COVERT (MD, MPH)	O P H T H A L M O L O G Y	MI
DIANE KATHERINE FIANDER (MD)	O P H T H A L M O L O G Y	MI
DR. JEREMY D WOLFE (MD)	O P H T H A L M O L O G Y	MI
LISA JANE FAIA (M.D.)	O P H T H A L M O L O G Y	MI
NATHAN FARLEY (MD)	O P H T H A L M O L O G Y	MI
OMAR MOHAMMED MOINUDDIN (MD)	O P H T H A L M O L O G Y	TX
DR. KIMBERLY ALYSON DRENSER (MD)	O P H T H A L M O L O G Y	MI
DR. GEORGE ARTHUR WILLIAMS (MD)	O P H T H A L M O L O G Y	MI
DR. ALAN RICHARD MARGHERIO (MD)	O P H T H A L M O L O G Y	MI

Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?

You can confirm Unknown Individual with NPI 1205863859; it appears in the national provider directory.

Should I trust care from Unknown Individual if status is inactive?

An inactive NPI does not by itself prove someone stopped practicing — check other sources.

Does Unknown Individual list a primary specialty?

If you are matching referrals, note Retina Specialist (Ophthalmology) Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.

Where is Unknown Individual's primary listing?

We display Novi, Michigan because that is what the record indicates for Unknown Individual.

Is this NPI for an individual or an organization?

This listing corresponds to an Individual Provider.