Unknown Individual – Optometrist, NPI 1487759619

Unknown Individual is a healthcare provider. based in Sauk centre, Minnesota. specializing in Optometrist. They hold a License No. 1709 (MN). The NPI Number for Unknown Individual is 1487759619

Main info

Organization
Inactive
48 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1487759619
Phone
(320) 352-2774
Address
314 MAIN ST S
Deactivation Date
14 June 2021

Doctor Profile

Medical School Name
SOUTHERN COLLEGE OF OPTOMETRY
Secondary Phone
3203522774
Graduation Year
1978 (48 years ago)
PAC ID
1759317605
Group Practice PAC ID
6800822859
Professional Enrollment ID
I20050712000578
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

  • 314, Main Street South, Sauk Centre, Stearns County, Minnesota, 56378, United States

    SAUK CENTRE, MN 563781349

    Phone: (320) 352-2774

    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 56378)

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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
OPTOMETRYMN92012Eye and medical examination for diagnosis and treatment, established patient2625

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: 6800822859View full group profile
NameSpecialtyState
-MN
O P T O M E T R YMN
O P T O M E T R YTX

Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1487759619 is assigned to Unknown Individual under the national enumeration system.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Optometrist. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Sauk Centre, Minnesota for Unknown Individual; download NPPES for the complete set.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1487759619. Always confirm identity and privileges with the practice and licensing boards.

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