Mikolaj Nowobilski, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3923-35 Issued in WI

Practice address

2860 S Green Bay Rd
Mt Pleasant, WI 53406-4962

Phone

(262) 637-3733

NPI assigned

Jun 20, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI, IL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shoptikal LLCGroup PAC ID 1456684471, 192 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Shoptikal LLC

  • Eyewear Supplier
  • Green Bay, WI
  • NPI 1659937159

  Optometrist

  Medicare reassignment Care Compare group NPD
• Shoptikal LLC

  • Eyewear Supplier
  • Dixon, IL
  • NPI 1699331082

  Optometrist

  Medicare reassignment NPD
• Shoptikal LLC

  • Eyewear Supplier
  • Waukesha, WI
  • NPI 1548826951

  Optometrist

  NPD
• Shoptikal LLC

  • Eyewear Supplier
  • Machesney Park, IL
  • NPI 1174138168

  Optometrist

  NPD
• Shoptikal LLC

  • Eyewear Supplier
  • Rockford, IL
  • NPI 1467311142

  Optometrist

  NPD
• Shoptikal LLC

  • Eyewear Supplier
  • Hales Corners, WI
  • NPI 1023691797

  Optometrist

  NPD (past)
• Shoptikal LLC

  • Eyewear Supplier
  • Mount Pleasant, WI
  • NPI 1790341162

  Optometrist

  NPD (past)
• Shoptikal LLC

  • Eyewear Supplier
  • Spokane, WA
  • NPI 1154987535

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1687219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1285319020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 S GREEN BAY RD",
            "city": "MT PLEASANT",
            "state": "WI",
            "postal_code": "534064962",
            "telephone_number": "262-637-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 S GREEN BAY RD",
            "city": "MT PLEASANT",
            "state": "WI",
            "postal_code": "534064962",
            "telephone_number": "262-637-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWOBILSKI",
        "first_name": "MIKOLAJ",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-20",
        "last_updated": "2023-06-20",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3923-35",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jack Conor Neylon
• Tran Nguyen
• Lateasha Nicole, SAC
• Mary Nilles, PT
• Sarantuya Nisler, APNP
• Nulife Therapy Services, LLC
• Catherine O'Neill, PT
• Brittany Diane Oakley, M.S. CCC-SLP
• Austin Oettinger
• Kelly Marie Oettinger, PHARMD

• Optometrist in Mt Pleasant, WI
• Providers in Mt Pleasant, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.