Unknown Individual – Optometrist, NPI 1225010960

Unknown Individual is a healthcare provider. based in Dayton, Ohio. specializing in Optometrist. They hold a License No. 3639/T674 (OH). The NPI Number for Unknown Individual is 1225010960

Main info

Organization
Inactive
44 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1225010960
Phone
(937) 434-2021
Address
6901 YANKEE ST
Deactivation Date
1 May 2024

Doctor Profile

Medical School Name
OHIO STATE UNIVERSITY - COLLEGE OF OPTOMETRY
Secondary Phone
4198855300
Graduation Year
1982 (44 years ago)
PAC ID
9234241498
Group Practice PAC ID
7719211010
Professional Enrollment ID
I20110920000271
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

  • Facial Aesthetics of Dayton, 8419, Yankee Street, Yankee Trace, Centerville, Washington Township, Montgomery County, Ohio, 45458, United States

    DAYTON, OH 454593321

    Phone: (937) 434-2021

    Type: Mailing

  • Far Hills Avenue, Oakwood, Montgomery County, Ohio, 45469, United States

    DAYTON, OH 454191505

    Phone: (937) 298-0550

    Fax: (937) 298-5404

    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.

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 45459)

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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
OPTOMETRYOH92134Diagnostic imaging of retina3427

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: 7719211010View full group profile
NameSpecialtyState
O P T O M E T R YVA
O P T O M E T R YOH
O P T O M E T R YOH
-AZ
O P T O M E T R YOH
O P T O M E T R YOH
O P T O M E T R YOH
O P T O M E T R YVA
O P T O M E T R YOH
-VA

Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1225010960 on file in the registry.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Optometrist. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Dayton, Ohio.
Can I trust this NPI listing for Unknown Individual?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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