Active NPI
Shoptikal LLC
Doing business as Shopko Optical 4099
- Eyewear Supplier
- Onalaska, WI
National Provider Identifier
1942866066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Eyewear Supplier
- Legal business name
- SHOPTIKAL LLC
- Doing business as
- Shopko Optical 4099
- Practice address
- 9417 State Road 16 Ste 300
Onalaska, WI 54650-8539 - Phone
- (608) 781-2010
- NPI assigned
- May 14, 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | NU | ||
| Eyewear Supplier | 332H00000X | NU | Primary |
Addresses
Primary practice location
9417 State Road 16 Ste 300
Onalaska, WI 54650-8539
Mailing address
PO Box 19060
Green Bay, WI 54307-9060
Other names 1
- Shopko Optical 4099
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190606001553 | WI | Part B Supplier - Clinic/Group Practice | 1456684471 |
Receives reassigned benefits from 185 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider Directory- Tax ID family
- Shoptikal LLC
Organizations with this tax ID in the same state 17
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
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
- La Crosse, WI
- NPI 1992268551
-
- Optometrist
- Eau Claire, WI
- NPI 1427008275
-
- Optometrist
- Rockford, IL
- NPI 1093157992
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557792000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1732838400000",
"number": "1942866066",
"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": "9417 STATE ROAD 16 STE 300",
"city": "ONALASKA",
"state": "WI",
"postal_code": "546508539",
"telephone_number": "608-781-2010"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SHOPTIKAL LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-05-14",
"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": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "332H00000X",
"taxonomy_group": "",
"desc": "Eyewear Supplier",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Shopko Optical 4099",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Shopko Optical 4099",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Onalaska, WI
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.