Unknown Individual – Optometrist, NPI 1477547735

Unknown Individual is a healthcare provider. based in Santa rosa, California. specializing in Optometrist. They hold a License No. 8603T (CA). The NPI Number for Unknown Individual is 1477547735

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1477547735
Phone
(707) 542-8883
Address
2655 CLEVELAND AVE
Deactivation Date
17 October 2022

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness85
Years active:0State licenses:1Other namesUpdated within 12 months

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Provider Addresses for Unknown Individual

  • 2655, Cleveland Avenue, Santa Rosa, Sonoma County, California, 95403, United States

    SUITE A

    SANTA ROSA, CA 954032779

    Phone: (707) 542-8883

    Fax: (707) 546-7787

    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 95403)

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Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1477547735.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Optometrist. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Santa Rosa, California may find Unknown Individual in results; validate coverage separately.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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