Active NPI
Luxottica Retail North America Inc
- Eyewear Supplier
- Rockford, IL
National Provider Identifier
1467518258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Eyewear Supplier
- Legal business name
- LUXOTTICA RETAIL NORTH AMERICA INC
- Practice address
- 7200 Harrison Ave
Mall at Cherryvale
Rockford, IL 61112-1017 - Phone
- (815) 332-5733
- NPI assigned
- Dec 28, 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
7200 Harrison Ave
Mall at Cherryvale
Rockford, IL 61112-1017
Mailing address
4000 Luxottica PL
Attn Medicare Dept
Mason, OH 45040-8114
Phone (815) 332-5733
Other names 1
- SEARS OPTICAL #C0053
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031222000477 | IL | Part B Supplier - Clinic/Group Practice | 2567366180 |
Receives reassigned benefits from 79 practitioners This NPI is an additional NPI on the enrollment Practice locations: Park Ridge, IL; Orland Park, IL; Oak Brook, IL; Northbrook, IL; Norridge, IL; Machesney Park, IL; Lincolnwood, IL; Lincolnshire, IL… |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167264000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1373414400000",
"number": "1467518258",
"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": "815-332-5733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7200 HARRISON AVE",
"address_2": "MALL AT CHERRYVALE",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611121017",
"telephone_number": "815-332-5733"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LUXOTTICA RETAIL NORTH AMERICA INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-28",
"last_updated": "2013-07-10",
"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 #C0053",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.