NPIMap

Organization Active NPI

Luxottica of America Inc

Doing business as Target Optical #1984

  • Eyewear Supplier
  • Green Bay, WI
National Provider Identifier
1659423275
Registry record updated Apr 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
LUXOTTICA OF AMERICA INC
Doing business as
Target Optical #1984
Practice address
1001 Cormier Rd
Green Bay, WI 54304-4404
Phone
(920) 499-5873
NPI assigned
Jan 16, 2007
Last updated
Apr 7, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2020

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

Authorized official

Name
Emilia Flamini
Title
Cfo, North America
Phone
(513) 765-6623

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X NU Primary

Addresses

Primary practice location

1001 Cormier Rd
Green Bay, WI 54304-4404

Mailing address

4000 Luxottica PL
Attn Medicare Dept
Mason, OH 45040-8144
Phone (920) 499-5873

Other names 1

  • TARGET OPTICAL #1984 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040126000092 WI Part B Supplier - Clinic/Group Practice 2567366180 Receives reassigned benefits from 18 practitioners
28 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rib Mountain, WI; Racine, WI; Milwaukee, WI; Menomonee Falls, WI; Madison, WI; Greenfield, WI; Green Bay, WI; Glendale, WI…

Other NPIs on the same Medicare enrollment 27

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 27

National Provider Directory

National Provider Directory

Locations

4850 S 74th St
Milwaukee, WI 53220
Phone (414) 282-3200

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586217600000",
    "number": "1659423275",
    "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": "450408144",
            "telephone_number": "920-499-5873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 CORMIER RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543044404",
            "telephone_number": "920-499-5873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUXOTTICA OF AMERICA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2020-04-07",
        "certification_date": "2020-04-07",
        "status": "A",
        "authorized_official_last_name": "FLAMINI",
        "authorized_official_first_name": "EMILIA",
        "authorized_official_title_or_position": "CFO, NORTH AMERICA",
        "authorized_official_telephone_number": "513-765-6623"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TARGET OPTICAL #1984",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TARGET OPTICAL #1984",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2020; 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.