Organization Active NPI

Luxottica Retail North America Inc

Doing business as Sears Optical #C0133

  • Eyewear Supplier
  • Niles, IL
National Provider Identifier
1982784617
Registry record updated Jul 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
LUXOTTICA RETAIL NORTH AMERICA INC
Doing business as
Sears Optical #C0133
Practice address
9440 N Milwaukee Ave
Golf Mill S/C
Niles, IL 60714-1210
Phone
(847) 803-7652
NPI assigned
Oct 17, 2006
Last updated
Jul 12, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2013

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

Authorized official

Name
Mr. Terry Kroth
Title
Specialist
Phone
(513) 765-3060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X NU Primary

Addresses

Primary practice location

9440 N Milwaukee Ave
Golf Mill S/C
Niles, IL 60714-1210

Mailing address

4000 Luxottica PL
Attn Medicare Dept
Mason, OH 45040-8114
Phone (847) 803-7652

Other names 1

  • SEARS OPTICAL #C0133 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031222000477 IL Part B Supplier - Clinic/Group Practice 2567366180 Receives reassigned benefits from 79 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Park Ridge, IL; Orland Park, IL; Oak Brook, IL; Northbrook, IL; Norridge, IL; Machesney Park, IL; Lincolnwood, IL; Lincolnshire, IL…

National Provider Directory

National Provider Directory

Locations

9440 N Milwaukee Ave
Golf ML SC
Niles, IL 60714
Phone (847) 803-7652

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373587200000",
    "number": "1982784617",
    "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": "847-803-7652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9440 N MILWAUKEE AVE",
            "address_2": "GOLF MILL S/C",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607141210",
            "telephone_number": "847-803-7652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUXOTTICA RETAIL NORTH AMERICA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2013-07-12",
        "status": "A",
        "authorized_official_last_name": "KROTH",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "SPECIALIST",
        "authorized_official_telephone_number": "513-765-3060",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SEARS OPTICAL #C0133",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Niles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2013; 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.