NPIMap

Organization Active NPI

Vision Mart Inc

  • Optician
  • Milwaukee, WI
National Provider Identifier
1366491227
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Legal business name
VISION MART INC
Practice address
12000 W Carmen Ave
Milwaukee, WI 53225-2116
Phone
(414) 462-1300
NPI assigned
May 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Ms. Vicki Dickman
Title
President
Phone
(414) 462-1300

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
OpticianGroup: 193200000X MULTI-SPECIALTY GROUP 156FX1800X Primary

Addresses

Primary practice location

12000 W Carmen Ave
Milwaukee, WI 53225-2116

Mailing address

12000 W Carmen Ave
Milwaukee, WI 53225-2116
Phone (414) 462-1300

Other identifiers 1

IdentifierTypeStateIssuer
38450000MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041011000151 WI Part B Supplier - Clinic/Group Practice 2163481516 Receives reassigned benefits from 9 practitioners
Practice locations: Brookfield, WI; Green Bay, WI; Milwaukee, WI; Oak Creek, WI; Sheboygan, WI; West Allis, WI; West Bend, WI

National Provider Directory

National Provider Directory
Tax ID family
Vision Mart Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2923 N 15th St
Sheboygan, WI 53083
Phone (920) 452-3900

Practitioners & affiliated clinicians

Practitioners 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1366491227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12000 W CARMEN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532252116",
            "telephone_number": "414-462-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12000 W CARMEN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532252116",
            "telephone_number": "414-462-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION MART INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "DICKMAN",
        "authorized_official_first_name": "VICKI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-462-1300",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38450000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.