SHOPKO OPTICAL 4050
NPI 1205492675
Eyewear Supplier in Fond Du Lac, WI
About Shopko Optical 4050 NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHOPKO OPTICAL 4050 (NPI 1205492675) is a healthcare organization registered as an eyewear supplier in Fond Du Lac, Wisconsin and active in the NPI registry since May 2019. The organization lists Russell Steinhorst, Evp & Cfo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Group Practice 1
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 4050 is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
187Medicare enrollment records show 187 clinicians reassign Medicare billing to Shopko Optical 4050, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. Listed here are the 20 practicing nearest to this location.
Nearest to this location (20)
See all 187Fond Du Lac, WI 54937
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 1205492675. It was assigned to this organization in the NPPES registry on May 11, 2019. The provider is doing business as Shopko Optical 4050.
Where is Shoptikal LLC located?
Shoptikal LLC is located at N6663 Rolling Meadows Dr Ste I, Fond Du Lac, WI 54937. The listed phone number is (920) 921-8290.
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 2 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.
# Shopko Optical 4050 · NPI 1205492675
Eyewear Supplier organization in Fond Du Lac, Wisconsin. Organization record, active in the CMS NPPES registry since May 11, 2019.
## Identity
- **NPI:** 1205492675 (Entity type: Organization)
- **Enumerated:** May 11, 2019
- **Primary specialty:** Eyewear Supplier · taxonomy 332H00000X
- **Legal business name:** Shoptikal Llc
- **Organization subpart:** No
- **Authorized official:** Russell Steinhorst, EVP & CFO
## Practice location
- **Address:** N6663 ROLLING MEADOWS DR STE I, Fond Du Lac, WI 54937-9501
- **Phone:** (920) 921-8290
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 187 clinicians (Optometry) reassign Medicare billing to this organization (form CMS-855R); 1 practice at this address and 2 within 10 miles; [full list](https://npiprofile.com/npi/1205492675/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 29, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1205492675) · Data from the CMS NPPES public registry.