Unknown Individual – Optometrist, NPI 1508851437

Unknown Individual is a healthcare provider. based in Boyertown, Pennsylvania. specializing in Optometrist. They hold a License No. OEG1377 (PA). The NPI Number for Unknown Individual is 1508851437

Main info

Organization
Inactive
57 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1508851437
Phone
(610) 367-2020
Address
704 E PHILADELPHIA AVE
Deactivation Date
22 May 2024

Doctor Profile

Medical School Name
PENNSYLVANIA COLLEGE OF OPTOMETRY
Secondary Phone
6103672020
Graduation Year
1969 (57 years ago)
PAC ID
9032206404
Group Practice PAC ID
0648416917
Professional Enrollment ID
I20100902000077
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

  • 704, East Philadelphia Avenue, Boyertown, Berks County, Pennsylvania, 19512, United States

    BOYERTOWN, PA 195122116

    Phone: (610) 367-2020

    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 19512)

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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: 0648416917View full group profile
NameSpecialtyState
O P T O M E T R YPA
O P T O M E T R YPA

Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1508851437.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Optometrist. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Boyertown?
Unknown Individual currently maps to Boyertown, Pennsylvania in this extract.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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