Unknown Individual – Optometrist, NPI 1528069747

Unknown Individual is a healthcare provider. based in Vienna, Virginia. specializing in Optometrist. They hold a License No. 0618000333 (VA). The NPI Number for Unknown Individual is 1528069747

Main info

Organization
Inactive
43 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1528069747
Phone
(703) 847-8899
Address
1950 OLD GALLOWS RD STE 520
Deactivation Date
31 July 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5713854600
Graduation Year
1983 (43 years ago)
PAC ID
1254480312
Group Practice PAC ID
0143448456
Professional Enrollment ID
I20100528000303
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 1950 OLD GALLOWS RD STE 520

    VIENNA, VA 221823970

    Phone: (703) 847-8899

    Fax: (866) 795-4020

    Type: Mailing

  • MyEyeDr., 1047, Edwards Ferry Road Northeast, Edwards Landing, Leesburg, Loudoun County, Virginia, 20176, United States

    LEESBURG, VA 201763347

    Phone: (703) 737-7798

    Fax: (703) 737-7889

    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 22182)

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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: 0143448456View 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 YDC
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
-VA
O P T O M E T R YVA
-VA

Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1528069747 when you need to reference Unknown Individual in forms, claims, or directories.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Optometrist. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Vienna, Virginia for Unknown Individual based on available NPPES addresses.
How can I contact Unknown Individual?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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