Unknown Individual – Ophthalmology Physician, NPI 1124094040

Unknown Individual is a healthcare provider. based in Warrenton, Virginia. specializing in Ophthalmology Physician. They hold a License No. 0101248353 (VA). The NPI Number for Unknown Individual is 1124094040

Main info

Organization
Inactive
67 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1124094040
Phone
(540) 349-1882
Address
20 ROCK POINTE LN STE 201
Deactivation Date
21 February 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5403491882
Graduation Year
1959 (67 years ago)
PAC ID
7719958487
Group Practice PAC ID
9335106814
Professional Enrollment ID
I20101008000991
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

  • Rock Pointe Lane, Warrenton, Fauquier County, Virginia, 20188, United States

    WARRENTON, VA 201862680

    Phone: (540) 349-1882

    Fax: (703) 738-7157

    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.

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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.

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 20186)

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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
OPHTHALMOLOGYVA92134Diagnostic imaging of retina812300

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: 9335106814View full group profile
NameSpecialtyState
O P H T H A L M O L O G YVA
O P H T H A L M O L O G YMA
O P H T H A L M O L O G YVA
O P H T H A L M O L O G YVA

Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1124094040 when you need to reference Unknown Individual in forms, claims, or directories.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Ophthalmology Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Warrenton, Virginia for Unknown Individual; expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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