Active NPI
Shoptikal LLC
Doing business as Shopko Optical 4308
- Eyewear Supplier
- Minot, ND
National Provider Identifier
1902606510
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Eyewear Supplier
- Legal business name
- SHOPTIKAL LLC
- Doing business as
- Shopko Optical 4308
- Practice address
- 1100 N Broadway Ste 110
Minot, ND 58703-1349 - Phone
- (701) 852-2020
- NPI assigned
- Mar 14, 2025
- Last updated
- Mar 14, 2025
- 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
- Ceo
- Phone
- (920) 429-7489
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | |||
| Eyewear Supplier | 332H00000X | Primary |
Addresses
Primary practice location
1100 N Broadway Ste 110
Minot, ND 58703-1349
Mailing address
PO Box 19060
Green Bay, WI 54307-9060
Phone (920) 429-2211
Other names 1
- Shopko Optical 4308
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20221031002549 | ND | Part B Supplier - Clinic/Group Practice | 1456684471 |
Receives reassigned benefits from 8 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Bismarck, ND; Fargo, ND; Minot, ND; Wahpeton, ND |
Other NPIs on the same Medicare enrollment 4
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Tax ID family
- Shoptikal LLC
Organizations with this tax ID in the same state 4
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": "1741910400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1741910400000",
"number": "1902606510",
"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",
"telephone_number": "920-429-2211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 N BROADWAY STE 110",
"city": "MINOT",
"state": "ND",
"postal_code": "587031349",
"telephone_number": "701-852-2020"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SHOPTIKAL LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-03-14",
"last_updated": "2025-03-14",
"certification_date": "2025-03-14",
"status": "A",
"authorized_official_last_name": "STEINHORST",
"authorized_official_first_name": "RUSSELL",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "920-429-7489"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": false
},
{
"code": "332H00000X",
"taxonomy_group": "",
"desc": "Eyewear Supplier",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Shopko Optical 4308",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Minot, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; 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.