Unknown Individual – Optometrist, NPI 1326096686

Unknown Individual is a healthcare provider. based in Maplewood, Minnesota. specializing in Optometrist. They hold a License No. 1635 (MN). The NPI Number for Unknown Individual is 1326096686

Main info

Organization
Inactive
50 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1326096686
Phone
(651) 777-3555
Address
1965 11TH AVE E
Deactivation Date
30 April 2026

Doctor Profile

Medical School Name
PACIFIC UNIVERSITY - COLLEGE OF OPTOMETRY
Secondary Phone
6517773555
Graduation Year
1976 (50 years ago)
PAC ID
2567422769
Group Practice PAC ID
3779543962
Professional Enrollment ID
I20100329001139
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

  • 11th Avenue, Maplewood, Ramsey County, Minnesota, 55109, United States

    MAPLEWOOD, MN 551095168

    Phone: (651) 777-3555

    Fax: (651) 777-4459

    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 55109)

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Provider's Procedures

Unknown Individual performs procedures in Optometrist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OPTOMETRYMN92083Measurement of field of vision during daylight conditions1818
OPTOMETRYMN92134Diagnostic imaging of retina2521

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: 3779543962View full group profile
NameSpecialtyState
O P T O M E T R YMN
O P T O M E T R YCO
O P T O M E T R YMN
O P T O M E T R YMN
O P T O M E T R YMN
O P T O M E T R YMN
O P T O M E T R YMN
O P T O M E T R YWA
-MN

Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1326096686.
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.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Optometrist in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Maplewood, Minnesota in the same public data insurers reference.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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Eye Care Center

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