Unknown Individual – Ophthalmology Physician, NPI 1720015472

Unknown Individual is a healthcare provider. based in Roseburg, Oregon. specializing in Ophthalmology Physician. They hold a License No. MD09792 (OR). The NPI Number for Unknown Individual is 1720015472

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1720015472
Phone
(541) 673-8988
Address
2750 W HARVARD AVE
Deactivation Date
5 April 2022
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

  • 2750, West Harvard Avenue, Roseburg, Douglas County, Oregon, 97471, United States

    ROSEBURG, OR 974702608

    Phone: (541) 673-8988

    Fax: (541) 672-8103

    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 97470)

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Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1720015472 as the unique 10-digit identifier.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Ophthalmology Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Roseburg?
Unknown Individual currently maps to Roseburg, Oregon in this extract.
Does Unknown Individual accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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