Active NPI
Luxottica of America Inc
Doing business as Target Optical #4314
- Eyewear Supplier
- Plymouth, MN
National Provider Identifier
1073665378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Eyewear Supplier
- Legal business name
- LUXOTTICA OF AMERICA INC
- Doing business as
- Target Optical #4314
- Practice address
- 4175 Vinewood LN N
Plymouth, MN 55442-2624 - Phone
- (763) 553-2883
- NPI assigned
- Jan 17, 2007
- Last updated
- Jul 11, 2025
- 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
4175 Vinewood LN N
Plymouth, MN 55442-2624
Mailing address
4000 Luxottica PL
Attn Medicare Dept
Mason, OH 45040-8114
Phone (763) 553-2883
Other names 1
- Target Optical #4314
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930057339 | MN | DME Supplier - Optician | 2567366180 | Practice locations: Plymouth, MN |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Target Optical #4314 | Prosthetic Lenses: Conventional Eyeglasses | Does not accept assignment |
National Provider Directory
National Provider Directory- Tax ID family
- Luxottica of America Inc
Organizations with this tax ID in the same state 13
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168992000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1752192000000",
"number": "1073665378",
"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": "763-553-2883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4175 VINEWOOD LN N",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554422624",
"telephone_number": "763-553-2883"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LUXOTTICA OF AMERICA INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-17",
"last_updated": "2025-07-11",
"certification_date": "2025-07-11",
"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": "Target Optical #4314",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Plymouth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.