Unknown Individual – Ophthalmology Physician, NPI 1962472480

Unknown Individual is a healthcare provider. based in Saint louis, Missouri. specializing in Ophthalmology Physician. They hold a License No. R4D77 (MO). The NPI Number for Unknown Individual is 1962472480

Main info

Organization
Inactive
46 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1962472480
Phone
(314) 771-3000
Address
3535 S JEFFERSON AVE STE S4
Deactivation Date
23 January 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3147713000
Graduation Year
1980 (46 years ago)
PAC ID
7012058167
Group Practice PAC ID
8820041031
Professional Enrollment ID
I20120223000033
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

Provider Addresses for Unknown Individual

  • 3535 S JEFFERSON AVE STE S4

    SAINT LOUIS, MO 631183900

    Phone: (314) 771-3000

    Fax: (314) 771-4094

    Type: Mailing

  • 8044 Manchester Rd

    St Louis, MO 63144

    Phone: (314) 647-4494

    Fax: (314) 781-9993

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 27 Open Payments records for all available years, with a total value of $1,099.

Total Amount is formed as General ($1,099) + Research ($0) + Ownership ($0) = $1,099.

Last reported payment date: 2024-11-18 • Largest payer in this snapshot: Bausch & Lomb Americas Inc. ($270).

Total Amount

$1,099

General + Research + Ownership

Payments

27

Total payment records

General Amount

$1,099

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-18

Latest reported date

Top Companies

Largest payers in this snapshot

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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.

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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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
92012Established patient problem focused exam of visual system205121$0
92014Established patient complete exam of visual system159147$0
92134Imaging of retina145109$0
92201Extended exam of the back part of the eye with retinal drawing141103$0
92202Extended exam of the back part of the eye with optic nerve drawing9678$0
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Insurance plans in this area (ZIP 63118)

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Provider's Procedures

Unknown Individual performs procedures in Ophthalmology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OPHTHALMOLOGYMO92083Measurement of field of vision during daylight conditions124122
OPHTHALMOLOGYMO92134Diagnostic imaging of retina12895

Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1962472480.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Ophthalmology Physician. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Saint Louis, Missouri in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
3 practice locations appear in the available data.

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