Unknown Individual – Optometrist, NPI 1710981691

Unknown Individual is a healthcare provider. based in Englewood, Ohio. specializing in Optometrist. They hold a License No. 4320 (OH). The NPI Number for Unknown Individual is 1710981691

Main info

Organization
Inactive
35 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1710981691
Phone
(937) 836-3041
Address
639 W NATIONAL RD
Deactivation Date
2 August 2022

Doctor Profile

Medical School Name
OHIO STATE UNIVERSITY - COLLEGE OF OPTOMETRY
Secondary Phone
9378363041
Graduation Year
1991 (35 years ago)
PAC ID
5193857928
Group Practice PAC ID
8527190354
Professional Enrollment ID
I20100714000796
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

  • 639, National Road, Morgan Place, Englewood, Montgomery County, Ohio, 45322, United States

    ENGLEWOOD, OH 453221155

    Phone: (937) 836-3041

    Fax: (937) 836-1937

    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.

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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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 45322)

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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
OPTOMETRYOH92083Measurement of field of vision during daylight conditions6562
OPTOMETRYOH92134Diagnostic imaging of retina2321

Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1710981691.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What does the directory say Unknown Individual does?
Insurance directories may phrase it differently, but here Unknown Individual maps to Optometrist. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Englewood, Ohio?
If you are local to Englewood, Ohio, Unknown Individual may be relevant to your search.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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