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SHOPKO EYECARE CENTER # 4216
NPI 1427547082
Eyewear Supplier in Mequon, WI

Active since May 08, 2018
10996 N PORT WASHINGTON RD, MEQUON, WI 53092(262) 240-9870 Get Directions Write a Review

NPPES record last updated: July 25, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 25, 2018, May 8, 2018 (2 updates tracked since 2018).

About Shopko Eyecare Center # 4216 NPPES

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

SHOPKO EYECARE CENTER # 4216 (NPI 1427547082) is a healthcare organization registered as an eyewear supplier in Mequon, Wisconsin and active in the NPI registry since May 2018. The organization lists Dilip Sedani, Vp, as its authorized official.

NPPES Registry Identity

NPI1427547082
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO LLC
Location Address10996 N PORT WASHINGTON RDMequon, WI 53092
Mailing Address700 Pilgrim WayGreen Bay, WI 54304-5263 · (920) 429-2211
Phone(262) 240-9870
Organization SubpartNo
Authorized OfficialDilip SedaniVp · (920) 429-7688
Enumeration DateMay 8, 2018
Last NPPES UpdateJuly 25, 20182 updates tracked since enumeration
✔ NPI 1427547082 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEyewear SupplierSuppliers
Taxonomy Code332H00000X
Definition
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
10996 N PORT WASHINGTON RD, Mequon, WI 53092
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Other Names 1

Doing Business AsShopko Eyecare Center # 4216

Other Identifiers 1

Medicaid1427547082WI

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PRANAYA BISTA
Optometrist
10996 N PORT WASHINGTON RD
MEQUON, WI 53092
Ozaukee County (262) 240-9870
SHOPTIKAL LLC
Eyewear Supplier
10996 N PORT WASHINGTON RD
MEQUON, WI 53092
Ozaukee County (262) 240-9870

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 Shopko Stores Operating Co LLC's NPI number?

The NPI number for Shopko Stores Operating Co LLC is 1427547082. It was assigned to this organization in the NPPES registry on May 8, 2018. The provider is doing business as Shopko Eyecare Center # 4216.

Where is Shopko Stores Operating Co LLC located?

Shopko Stores Operating Co LLC is located at 10996 N Port Washington Rd, Mequon, WI 53092. The listed phone number is (262) 240-9870.

What is Shopko Stores Operating Co LLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Shopko Stores Operating Co LLC was last updated on July 25, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years 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.