Menomonie Eye & Optical LLC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

MENOMONIE EYE & OPTICAL LLC

Practice address

520 Wilson Ave
Menomonie, WI 54751-2516

Phone

(715) 235-2855

Fax

(715) 235-9436

NPI assigned

Jun 28, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Nicholas J Komro, ODNPI 1750373585

Title

Authorized Member

Phone

(715) 235-2855

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI2 enrollments

Enrollment records 2

These 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

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicholas Joel Komro, OD

  • Optometrist
  • Menomonie, WI
  • NPI 1750373585
  Medicare reassignment Care Compare group NPD Authorized official
• Marianne R Celli Komro, OD

  • Optometrist
  • Eau Claire, WI
  • NPI 1366421182
  Medicare reassignment Care Compare group NPD
• Coad Thomas Dow, MD

  • Ophthalmology Physician
  • Eau Claire, WI
  • NPI 1619969441
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194922690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 WILSON AVE",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547512516",
            "telephone_number": "715-235-2855",
            "fax_number": "715-235-9436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 WILSON AVE",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547512516",
            "telephone_number": "715-235-2855",
            "fax_number": "715-235-9436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENOMONIE EYE & OPTICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOMRO",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "AUTHORIZED MEMBER",
        "authorized_official_telephone_number": "715-235-2855",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38721600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelley Rae Mendalski, M.S., LPC
• Menomonie Area Senior Center
• Menomonie CBRF, LLC
• Menomonie Chiropractic Center SC
• Menomonie Dental, LLC
• Menomonie Rcac, LLC
• Amber Lynn Meronek, LPN
• Christian Nicholas Meyer, DC
• Hannah Kay Meyer, SLP
• Hunter John Meyers, DO

• Eyewear Supplier in Menomonie, WI
• Providers in Menomonie, WI by specialty
• Eyewear Supplier in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.

Verify at the official NPI Registry.