Active NPI
Shoptikal LLC
Doing business as Shopko Optical 4016
- Eyewear Supplier
- Escanaba, MI
National Provider Identifier
1598321911
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Eyewear Supplier
- Legal business name
- SHOPTIKAL LLC
- Doing business as
- Shopko Optical 4016
- Practice address
- 2502 3Rd Ave N
Escanaba, MI 49829-1323 - Phone
- (906) 786-2295
- NPI assigned
- May 10, 2019
- Last updated
- Nov 29, 2024
- 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
- Russell Steinhorst
- Title
- Evp & Cfo
- Phone
- (920) 429-7489
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Eyewear Supplier | 332H00000X | NU | Primary | |
| Optometrist | 152W00000X | NU |
Addresses
Primary practice location
2502 3Rd Ave N
Escanaba, MI 49829-1323
Mailing address
PO Box 19060
Green Bay, WI 54307-9060
Other names 1
- Shopko Optical 4016
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190708001548 | MI | Part B Supplier - Clinic/Group Practice | 1456684471 |
Receives reassigned benefits from 5 practitioners 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Escanaba, MI; Houghton, MI; Iron Mountain, MI; Marquette, MI |
Other NPIs on the same Medicare enrollment 3
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Shopko Optical 4011
- Eyewear Supplier
- Iron Mountain, MI
- NPI 1831755255
O20190708001548
National Provider Directory
National Provider Directory- Tax ID family
- Shoptikal LLC
Organizations with this tax ID in the same state 3
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
Locations
2502 3rd Ave N
Escanaba, MI 49829
Phone (906) 786-2295
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Optometrist
- Petoskey, MI
- NPI 1730196262
-
- Optometrist
- Marquette, MI
- NPI 1134170145
-
- Optometrist
- Iron Mountain, MI
- NPI 1093442121
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557446400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1732838400000",
"number": "1598321911",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 19060",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543079060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2502 3RD AVE N",
"city": "ESCANABA",
"state": "MI",
"postal_code": "498291323",
"telephone_number": "906-786-2295"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SHOPTIKAL LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-05-10",
"last_updated": "2024-11-29",
"certification_date": "2024-11-29",
"status": "A",
"authorized_official_last_name": "STEINHORST",
"authorized_official_first_name": "RUSSELL",
"authorized_official_title_or_position": "EVP & CFO",
"authorized_official_telephone_number": "920-429-7489"
},
"taxonomies": [
{
"code": "332H00000X",
"taxonomy_group": "",
"desc": "Eyewear Supplier",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Shopko Optical 4016",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Shopko Optical 4016",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Escanaba, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2024; 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.