SHOPKO OPTICAL 4177
NPI 1194381509
Eyewear Supplier in Green Bay, WI

Active since May 13, 2019
2314 LINEVILLE RD STE 104, GREEN BAY, WI 54313(920) 434-5845 Get Directions Write a Review

NPPES record last updated: November 29, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 10, 2021, Apr 15, 2020, Oct 23, 2019 and 1 more (4 updates tracked since 2019).

About Shopko Optical 4177 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHOPKO OPTICAL 4177 (NPI 1194381509) is a healthcare organization registered as an eyewear supplier in Green Bay, Wisconsin and active in the NPI registry since May 2019. The organization lists Russ Steinhorst, Evp & Cfo, as its authorized official.

NPPES Registry Identity

NPI1194381509
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPTIKAL LLC
Location Address2314 LINEVILLE RD STE 104Green Bay, WI 54313-8860
Mailing AddressP.o. Box 19060Green Bay, WI 54307
Organization SubpartNo
Authorized OfficialRuss SteinhorstEvp & Cfo · (920) 429-7842
Enumeration DateMay 13, 2019
Last NPPES UpdateNovember 29, 20244 updates tracked since enumeration
NPPES CertifiedNovember 29, 2024
✔ NPI 1194381509 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEyewear SupplierSuppliers
Taxonomy Code332H00000X
Definition
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
Also ListedOptometristTaxonomy 152W00000X
2314 LINEVILLE RD STE 104, Green Bay, WI 54313

Other Names 1

Doing Business AsShopko Optical 4177

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shopko Optical 4177 is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

187

Medicare enrollment records show 187 clinicians reassign Medicare billing to Shopko Optical 4177, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 10 within 10 miles. Listed here are the 20 practicing nearest to this location.

Nearest to this location (20)

See all 187
Optometry
NPI 1629636105
2314 LINEVILLE RD STE 104
Suamico, WI 54313
(920) 434-5845
✔ PECOS✔ Accepts MedicareSame address
Optometry
NPI 1396031951
2485 LINEVILLE RD STE 102
Green Bay, WI 54313
(920) 857-3700
✔ PECOS✔ Accepts Medicare0.4 mi
Optometry
NPI 1003838129
2793 LINEVILLE RD
Green Bay, WI 54313
(920) 496-4700
✔ PECOS✔ Accepts Medicare1.0 mi
Optometry
NPI 1003867961
216 S MILITARY AVE
Green Bay, WI 54303
(920) 494-3384
✔ PECOS✔ Accepts Medicare4.2 mi
1515 6TH ST
Green Bay, WI 54304
(920) 499-2147
✔ PECOS✔ Accepts Medicare5.0 mi
Optometry
NPI 1205090990
700 PILGRIM WAY
Green Bay, WI 54304
(920) 733-3846
✔ PECOS✔ Accepts Medicare7.5 mi
Optometry
NPI 1316674625
2621 S ONEIDA ST
Green Bay, WI 54304
(920) 499-3511
✔ PECOS✔ Accepts Medicare7.8 mi
Optometry
NPI 1457843161
230 N WISCONSIN ST
De Pere, WI 54115
(920) 336-3390
✔ PECOS✔ Accepts Medicare9.7 mi
Optometry
NPI 1093767931
230 N WISCONSIN ST
De Pere, WI 54115
(920) 336-3390
✔ PECOS✔ Accepts Medicare9.8 mi
Optometry
NPI 1952392003
723 MAIN AVE
De Pere, WI 54115
(920) 336-3390
✔ PECOS9.9 mi
Optometry
NPI 1023105772
1301 E NORTHLAND AVE SUITE A
Appleton, WI 54911
(920) 734-8714
✔ PECOS✔ Accepts Medicare26 mi
Optometry
NPI 1396714812
3329 N RICHMOND ST
Appleton, WI 54911
(920) 380-2715
✔ PECOS✔ Accepts Medicare27 mi
Optometry
NPI 1417908955
1000 W NORTHLAND AVE
Appleton, WI 54914
(920) 731-4511
✔ PECOS✔ Accepts Medicare27 mi
Optometry
NPI 1336435445
1033 W NORTHLAND AVE STE B
Appleton, WI 54914
(920) 731-4511
✔ PECOS✔ Accepts Medicare27 mi
Optometry
NPI 1114043387
150A COUNTY ROAD B
Shawano, WI 54166
(715) 526-3163
✔ PECOS✔ Accepts Medicare29 mi
Optometry
NPI 1114074416
4301 W WISCONSIN AVE
Appleton, WI 54913
(920) 730-8770
✔ PECOS✔ Accepts Medicare30 mi
Optometry
NPI 1407966658
955 MUTUAL WAY
Appleton, WI 54913
(920) 954-6600
✔ PECOS✔ Accepts Medicare30 mi
Optometry
NPI 1881647030
1640 APPLETON RD
Menasha, WI 54952
(920) 725-3752
✔ PECOS✔ Accepts Medicare30 mi
Optometry
NPI 1073207445
1255 APPLETON RD
Menasha, WI 54952
(920) 722-6872
✔ PECOS✔ Accepts Medicare31 mi
Optometry
NPI 1447489661
150A COUNTY RD B
Shawano, WI 54166
(715) 526-3163
✔ PECOS✔ Accepts Medicare31 mi
See all 187 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shoptikal LLC's NPI number?

The NPI number for Shoptikal LLC is 1194381509. It was assigned to this organization in the NPPES registry on May 13, 2019. The provider is doing business as Shopko Optical 4177.

Where is Shoptikal LLC located?

Shoptikal LLC is located at 2314 Lineville Rd Ste 104, Green Bay, WI 54313. The listed phone number is (920) 434-5845.

What is Shoptikal LLC's specialty?

The primary specialty registered for this NPI is Eyewear Supplier with taxonomy code 332H00000X.

Is Shoptikal LLC enrolled in Medicare?

Yes. Shoptikal LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Shoptikal LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 187 clinicians, all in Optometry, reassign their Medicare billing to Shoptikal LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 10 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Shoptikal LLC accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana and HealthPartners and 2 other insurers list Shoptikal LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shoptikal LLC was last updated on November 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.