Unknown Individual – Retina Specialist (Ophthalmology) Physician, NPI 1841275427

Retina Specialist (Ophthalmology) Physician

Unknown Individual is a healthcare provider. based in Jackson, Michigan. specializing in Retina Specialist (Ophthalmology) Physician. They hold a License No. 4301059936 (MI). The NPI Number for Unknown Individual is 1841275427

Main info

Organization

Inactive

39 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1841275427

Phone

(877) 852-8463

Address

850 W NORTH ST

Deactivation Date

3 May 2023

Doctor Profile

Medical School Name

JEFFERSON MEDICAL COLLEGE OF THOMAS JEFFERSON UNIVERSITY

Secondary Phone

9892243937

Graduation Year

1987 (39 years ago)

PAC ID

0547162612

Group Practice PAC ID

4486566098

Professional Enrollment ID

I20080112000085

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

850, West North Street, Jackson, Jackson County, Michigan, 49202, United States
STE. 104
JACKSON, MI 492023196
Phone: (877) 852-8463
Fax: (517) 817-0144
Type: Mailing
1515, Lake Lansing Road, Lansing Charter Township, Ingham County, Michigan, 48912, United States
STE. H
LANSING, MI 489123752
Phone: (517) 487-6511
Fax: (517) 487-1331
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.

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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 49202)

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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	92083	Measurement of field of vision during daylight conditions	58	50

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: 4486566098View full group profile

Name	Specialty	State
JAMIE MARIE SHAY (OD)	O P T O M E T R Y	MI
MARCUS RHEM (M.D.)	O P H T H A L M O L O G Y	MI
DR. CLINT DOUGLAS SIMPSON (M.D.)	O P H T H A L M O L O G Y	MI
ALEXANDER JAMES CHERRY (M.D.)	O P H T H A L M O L O G Y	KY
KUNJAL PATEL (OD)	O P T O M E T R Y	MI
LINDSAY KATHARINE KLUMPP (O.D.)	O P T O M E T R Y	MI
MR. SURENDAR S PUROHIT (M.D.)	O P H T H A L M O L O G Y	MI
DR. KEVIN BENJAMIN VANDENBOSCH (O.D.)	O P T O M E T R Y	MI
DR. NINA GLAUCH (O.D.)	O P T O M E T R Y	MI
MAHMOUD H EL-YASSIR (MD)	O P H T H A L M O L O G Y	MI

Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1841275427?

NPI 1841275427 belongs to Unknown Individual; compare other details if you need extra assurance.

Is Unknown Individual still active if the NPI shows inactive?

NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.

What kind of doctor is Unknown Individual?

Unknown Individual is associated with Retina Specialist (Ophthalmology) Physician in the directory — Clinical services aligned with this taxonomy classification.

Is Unknown Individual associated with Jackson?

Public fields place Unknown Individual around Jackson, Michigan. Always confirm the exact site before visiting.

What does 2 location(s) imply?

2 practice locations appear in the available data.