NPIMap

Organization Active NPI

Luxottica of America Inc.

Doing business as Target Optical #C4052

  • Eyewear Supplier
  • Appleton, WI
National Provider Identifier
1780776245
Registry record updated Mar 8, 2019
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 #C4052
Target Optical #4052
Practice address
1800 S Kensington Dr
Appleton, WI 54915-4136
Phone
(920) 749-9785
NPI assigned
Sep 29, 2006
Last updated
Mar 8, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2019

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 Primary

Addresses

Primary practice location

1800 S Kensington Dr
Appleton, WI 54915-4136

Mailing address

4000 Luxottica PL
Attn Medicare Dept
Mason, OH 45040-8114
Phone (920) 749-9785

Other names 2

  • TARGET OPTICAL #C4052 Doing business as
  • Target Optical #4052 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

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": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552003200000",
    "number": "1780776245",
    "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": "920-749-9785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 S KENSINGTON DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549154136",
            "telephone_number": "920-749-9785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUXOTTICA OF AMERICA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2019-03-08",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TARGET OPTICAL #C4052",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Target Optical #4052",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2019; 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.