NPIMap

Organization Active NPI

Eyemart Express LLC

  • Eyewear Supplier
  • Manitowoc, WI
National Provider Identifier
1730657289
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
EYEMART EXPRESS LLC
Practice address
4140 Harbor Town LN
Manitowoc, WI 54220-5851
Phone
(920) 260-4205
NPI assigned
Nov 2, 2018
Organization subpart
Yes
Parent organization
EYEMART EXPRESS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Authorized official

Name
Kim Caruso
Title
Director of Credentialing
Phone
(646) 660-1992

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

4140 Harbor Town LN
Manitowoc, WI 54220-5851

Mailing address

4140 Harbor Town LN
Manitowoc, WI 54220-5851
Phone (920) 260-4205

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240905003067 WI DME Supplier - Optician 7911228622 Practice locations: Manitowoc, WI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Eyemart Express4140 Harbor Town LN, Manitowoc, WI 54220-5851(920) 260-4205 Prosthetic Lenses: Conventional Eyeglasses Accepts assignmentParticipating since Dec 6, 2024

National Provider Directory

National Provider Directory
Tax ID family
Eyemart Express292 organizations share this tax ID, including this one
Part of
Eyemart Express

Organizations with this tax ID in the same state 8

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

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

{
    "created_epoch": "1541116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780444800000",
    "number": "1730657289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 HARBOR TOWN LN",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542205851",
            "telephone_number": "920-260-4205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 HARBOR TOWN LN",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542205851",
            "telephone_number": "920-260-4205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYEMART EXPRESS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EYEMART EXPRESS LLC",
        "enumeration_date": "2018-11-02",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A",
        "authorized_official_last_name": "CARUSO",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "646-660-1992"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manitowoc, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.