Active NPI
Wisconsin Vision, LLC
- Optometrist
- Glendale, WI
National Provider Identifier
1023324811
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- WISCONSIN VISION, LLC
- Practice address
- 5530 N Port Washington Rd Unit C
Glendale, WI 53217-4920 - Phone
- (262) 432-2005
- Fax
- (262) 432-2006
- NPI assigned
- Aug 31, 2010
- Organization subpart
- Yes
- Parent organization
- LUXOTTICA OF AMERICA INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Darren Thomas Horndasch
- Title
- President
- Phone
- (262) 432-2005
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | Primary |
Addresses
Primary practice location
5530 N Port Washington Rd Unit C
Glendale, WI 53217-4920
Mailing address
16800 W Cleveland Ave
New Berlin, WI 53151-3533
Phone (262) 432-2005
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 65652 | Other | SPECTERA PROVIDER NO | |
| 68393 | Other | DAVIS VISION PROVIDER NO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040220000706 | WI | Part B Supplier - Clinic/Group Practice | 5698676518 |
Receives reassigned benefits from 65 practitioners 26 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Menomonee Falls, WI; West Allis, WI; Milwaukee, WI; Mount Pleasant, WI; Oshkosh, WI; Pewaukee, WI; Racine, WI; Sheboygan, WI… |
| O20101202000133 | WI | DME Supplier - Physician - Optometrist | 5698676518 | Practice locations: Glendale, WI |
Other NPIs on the same Medicare enrollment 26
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Part of
- Jacobsen OD
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
5530 N Port Washington Rd
Unit C
Glendale, WI 53217
Phone (414) 897-0152
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Optometrist
- Racine, WI
- NPI 1447246046
-
- Optometrist
- Pomona, CA
- NPI 1356375463
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283212800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1772409600000",
"number": "1023324811",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16800 W CLEVELAND AVE",
"city": "NEW BERLIN",
"state": "WI",
"postal_code": "531513533",
"telephone_number": "262-432-2005",
"fax_number": "262-432-2006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5530 N PORT WASHINGTON RD UNIT C",
"city": "GLENDALE",
"state": "WI",
"postal_code": "532174920",
"telephone_number": "262-432-2005",
"fax_number": "262-432-2006"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WISCONSIN VISION, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "LUXOTTICA OF AMERICA INC",
"enumeration_date": "2010-08-31",
"last_updated": "2026-03-02",
"certification_date": "2026-03-02",
"status": "A",
"authorized_official_last_name": "HORNDASCH",
"authorized_official_first_name": "DARREN",
"authorized_official_middle_name": "THOMAS",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "262-432-2005",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPECTERA PROVIDER NO",
"identifier": "65652",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DAVIS VISION PROVIDER NO",
"identifier": "68393",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Glendale, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.