Unknown Individual – Optometrist, NPI 1285616953

Unknown Individual is a healthcare provider. based in Muskegon, Michigan. specializing in Optometrist. They hold a License No. 4901002533 (MI). The NPI Number for Unknown Individual is 1285616953

Main info

Organization
Inactive
51 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1285616953
Phone
(231) 739-9009
Address
1266 E SHERMAN BLVD
Deactivation Date
16 August 2023

Doctor Profile

Medical School Name
ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Secondary Phone
2317399009
Graduation Year
1975 (51 years ago)
PAC ID
2668412974
Group Practice PAC ID
3678537628
Professional Enrollment ID
I20050505000966
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

  • East Sherman Boulevard, Muskegon, Muskegon County, Michigan, 49444, United States

    MUSKEGON, MI 494441847

    Phone: (231) 739-9009

    Fax: (231) 733-0566

    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.

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

Insurance plans in this area (ZIP 49444)

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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: 3678537628View full group profile
NameSpecialtyState
-MI
O P T O M E T R YMI
-MI
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 T O M E T R YMI
-MI
O P H T H A L M O L O G YMI
O P T O M E T R YMI

Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1285616953?
NPI 1285616953 belongs to Unknown Individual; compare other details if you need extra assurance.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Optometrist in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Muskegon, Michigan.
Does Unknown Individual accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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