Unknown Individual – Optometrist, NPI 1023002557

Unknown Individual is a healthcare provider. based in Virginia beach, Virginia. specializing in Optometrist. They hold a License No. 0601001614 (VA). The NPI Number for Unknown Individual is 1023002557

Main info

Organization
Inactive
37 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1023002557
Phone
(757) 425-5550
Address
1201 FIRST COLONIAL RD
Deactivation Date
19 April 2022

Doctor Profile

Medical School Name
SOUTHERN COLLEGE OF OPTOMETRY
Secondary Phone
7573512020
Graduation Year
1989 (37 years ago)
PAC ID
5991704371
Group Practice PAC ID
8921064460
Professional Enrollment ID
I20110413000876
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

  • 1201, First Colonial Road, Virginia Beach, Virginia, 23454, United States

    VIRGINIA BEACH, VA 234542217

    Phone: (757) 425-5550

    Fax: (757) 412-2606

    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 23454)

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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
OPTOMETRYVA92012Eye and medical examination for diagnosis and treatment, established patient339242
OPTOMETRYVA92083Measurement of field of vision during daylight conditions11795
OPTOMETRYVA92134Diagnostic imaging of retina4038

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: 8921064460View full group profile
NameSpecialtyState
O P T O M E T R YVA
O P T O M E T R YVA
O P T O M E T R YVA
O P T O M E T R YAP
O P H T H A L M O L O G YLA
O P T O M E T R YVA
O P H T H A L M O L O G YVA
-VA
O P T O M E T R YVA
O P H T H A L M O L O G YVA

Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1023002557 for Unknown Individual, then check state licensing separately.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual best known for clinically?
Directory data describes Unknown Individual with Optometrist. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Virginia Beach, Virginia; more addresses can appear in NPPES.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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