SHOPKO OPTICAL 061
NPI 1063465789
Eyewear Supplier in Saint Cloud, MN

NPI Status: Active since May 17, 2006

Contact Information

501 HIGHWAY 10 SE
SAINT CLOUD, MN
ZIP 56304
Phone: (320) 253-4695

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  • Organization
  • Eyewear Supplier

About SHOPKO OPTICAL 061

This page provides the complete NPI Profile along with additional information for Shopko Optical 061, a provider established in Saint Cloud, Minnesota operating as a Eyewear Supplier. The healthcare provider is registered in the NPI registry with number 1063465789 assigned on May 2006. The practitioner's primary taxonomy code is 332H00000X. The provider is registered as an organization and their NPI record was last updated 18 years ago. The provider's is doing business as Shopko Optical 061. The authorized official of this NPI record is Michael J Bettiga Rph (Sr. Vice President Health Services)

NPI
1063465789
Provider Legal Name
SHOPKO STORES OPERATING CO. LLC
Other Organization Name
SHOPKO OPTICAL 061
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
501 HIGHWAY 10 SE SAINT CLOUD, MN 56304
Location Phone
(320) 253-4695
Mailing Address
501 HIGHWAY 10 SE SAINT CLOUD, MN 56304
Mailing Phone
(320) 253-4695
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-17-2006
Last Update Date
04-15-2008
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Eyewear Supplier

Taxonomy Code
332H00000X
Type
Suppliers
Taxonomy Description
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MICHAEL J BETTIGA RPH

Authorized Official Title
SR. VICE PRESIDENT HEALTH SERVICES
Authorized Official Phone
(920) 429-4297

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
42497OTHER (01)DAVIS
35480OTHER (01)AVESIS
1111590022MEDICARE ID-TYPE UNSPECIFIED (04) 
014061OTHER (01)VIP
5695760083MEDICARE NSC (07)MN 
17832OTHER (01)MEDICARE
21527OTHER (01)MN HEALTH PARTNERS
55306HAOTHER (01)MN MA FIRST PLAN OF MN
20019120524OTHER (01)MN MA PRIMEWEST HEALTH
410985054-4061OTHER (01)NATIONAL VISION ADMIN.
C04276MEDICARE PIN (08) 
2100301OTHER (01)MN MA MEDICA CHOICE CARE
213121-17OTHER (01)EYEMED
26887SHOTHER (01)MN MA FIRST PLAN OF MN
DF0849MEDICARE PIN (08) 

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1063465789, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
3
Unchanged
Pos 5
4
Doubled → 8
Pos 6
6
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
7
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
9
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 4 → 8 5 → 10 → 1 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 1 + 2 + 3 + 8 + 6 + 1 + 0 + 7 + 1 + 6 + 24 = 61

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 61 is 70. The difference is the calculated check digit.

70 - 61 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1063465789.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Pharmacy (Community/Retail Pharmacy)
501 HIGHWAY 10 SE
SAINT CLOUD, MN 56304

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1063465789, enumerated as an "organization" on May 17, 2006.

The provider is located at 501 HIGHWAY 10 SE SAINT CLOUD, MN 56304 and the phone number is (320) 253-4695.

Eyewear Supplier with taxonomy code 332H00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.