Active NPI
Luxottica Retail North America Inc
- Eyewear Supplier
- Madison, WI
National Provider Identifier
1063500338
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Eyewear Supplier
- Legal business name
- LUXOTTICA RETAIL NORTH AMERICA INC
- Practice address
- 53 W Towne Mall
Madison, WI 53719-1019 - Phone
- (608) 829-3041
- NPI assigned
- Oct 11, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Terry Kroth
- Title
- Specialist
- Phone
- (513) 765-3060
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Eyewear Supplier | 332H00000X | Primary |
Addresses
Primary practice location
53 W Towne Mall
Madison, WI 53719-1019
Mailing address
4000 Luxottica PL
Attn Medicare Dept
Mason, OH 45040-8114
Phone (608) 829-3041
Other names 1
- SEARS OPTICAL #1439
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040126000092 | WI | Part B Supplier - Clinic/Group Practice | 2567366180 |
Receives reassigned benefits from 18 practitioners 28 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Rib Mountain, WI; Racine, WI; Milwaukee, WI; Menomonee Falls, WI; Madison, WI; Greenfield, WI; Green Bay, WI; Glendale, WI… |
Other NPIs on the same Medicare enrollment 27
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1373846400000",
"number": "1063500338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4000 LUXOTTICA PL",
"address_2": "ATTN MEDICARE DEPT",
"city": "MASON",
"state": "OH",
"postal_code": "450408114",
"telephone_number": "608-829-3041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "53 W TOWNE MALL",
"city": "MADISON",
"state": "WI",
"postal_code": "537191019",
"telephone_number": "608-829-3041"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LUXOTTICA RETAIL NORTH AMERICA INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-11",
"last_updated": "2013-07-15",
"status": "A",
"authorized_official_last_name": "KROTH",
"authorized_official_first_name": "TERRY",
"authorized_official_title_or_position": "SPECIALIST",
"authorized_official_telephone_number": "513-765-3060",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "332H00000X",
"taxonomy_group": "",
"desc": "Eyewear Supplier",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "SEARS OPTICAL #1439",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2013; 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.