SHOPKO OPTICAL 4059
NPI 1649836016
Eyewear Supplier in Fairmont, MN

Active since May 11, 2019
1023 E BLUE EARTH AVE, FAIRMONT, MN 56031(507) 238-9490 Get Directions Write a Review

NPPES record last updated: November 29, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 7, 2020, May 11, 2019 (2 updates tracked since 2019).

About Shopko Optical 4059 NPPES

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

SHOPKO OPTICAL 4059 (NPI 1649836016) is a healthcare organization registered as an eyewear supplier in Fairmont, Minnesota and active in the NPI registry since May 2019. The organization lists Russell Steinhorst, Evp & Cfo, as its authorized official.

NPPES Registry Identity

NPI1649836016
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPTIKAL LLC
Location Address1023 E BLUE EARTH AVEFairmont, MN 56031-4076
Mailing AddressPo Box 19060Green Bay, WI 54307-9060
Organization SubpartNo
Authorized OfficialRussell SteinhorstEvp & Cfo · (920) 429-7489
Enumeration DateMay 11, 2019
Last NPPES UpdateNovember 29, 20242 updates tracked since enumeration
NPPES CertifiedNovember 29, 2024
✔ NPI 1649836016 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
1023 E BLUE EARTH AVE, Fairmont, MN 56031

Other Names 1

Doing Business AsShopko Optical 4059

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 4059 is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

37

Medicare enrollment records show 37 clinicians reassign Medicare billing to Shopko Optical 4059, which bills Medicare for the services they deliver. Listed here are the 20 practicing nearest to this location.

Nearest to this location (20)

See all 37
Optometry
NPI 1891884771
230 10TH ST
Windom, MN 56101
(507) 831-3478
✔ PECOS✔ Accepts Medicare37 mi
Optometry
NPI 1023090396
1701 MADISON AVE
Mankato, MN 56001
(507) 387-6517
✔ PECOS✔ Accepts Medicare43 mi
Optometry
NPI 1689382020
300 WESTERN AVE NW STE 100 1/2
Faribault, MN 55021
(916) 747-0029
✔ PECOS✔ Accepts Medicare72 mi
Optometry
NPI 1164529384
318 N MAIN ST
Austin, MN 55912
(507) 437-7768
✔ PECOS✔ Accepts Medicare74 mi
Optometry
NPI 1770694986
1060 HWY 15 SOUTH MIDWEST VISION
Hutchinson, MN 55350
(320) 587-2370
✔ PECOS✔ Accepts Medicare85 mi
Optometry
NPI 1235180233
1200 SUSAN DR
Marshall, MN 56258
(507) 537-9652
✔ PECOS✔ Accepts Medicare85 mi
Optometry
NPI 1851063952
1420 E COLLEGE DR
Marshall, MN 56258
(320) 226-1237
✔ PECOS✔ Accepts Medicare86 mi
Optometry
NPI 1578026738
18484 KACHINA CT
Lakeville, MN 55044
(952) 993-3150
✔ PECOS✔ Accepts Medicare92 mi
Optometry
NPI 1457303505
352 S MAIN ST
Zumbrota, MN 55992
(507) 732-5013
✔ PECOS99 mi
Optometry
NPI 1427155654
200 1ST ST SW
Rochester, MN 55905
(507) 284-2511
✔ PECOS✔ Accepts Medicare102 mi
Optometry
NPI 1811336043
4559 290TH AVE
Clarkfield, MN 56223
(701) 388-9476
✔ PECOS✔ Accepts Medicare103 mi
Optometry
NPI 1942401039
13334 BASS LAKE RD
Maple Grove, MN 55311
(763) 496-1625
✔ PECOS✔ Accepts Medicare110 mi
Optometry
NPI 1043699317
21615 S DIAMOND LAKE RD
Rogers, MN 55374
(763) 428-9014
✔ PECOS✔ Accepts Medicare116 mi
Optometry
NPI 1902929391
749 APOLLO DR
Lino Lakes, MN 55014
(651) 784-7625
✔ PECOS✔ Accepts Medicare125 mi
Optometry
NPI 1902878127
6303 OSGOOD AVE N
Stillwater, MN 55082
(651) 439-4265
✔ PECOS✔ Accepts Medicare126 mi
Optometry
NPI 1881634806
4161 2ND ST S SHOPKO OPTICAL
Saint Cloud, MN 56301
(320) 253-5994
✔ PECOS✔ Accepts Medicare132 mi
Optometry
NPI 1285833624
4118 W DIVISION ST
Saint Cloud, MN 56301
(320) 251-2020
✔ PECOS✔ Accepts Medicare132 mi
Optometry
NPI 1427288554
2824 W DIVISION ST
Saint Cloud, MN 56301
(954) 218-2008
✔ PECOS✔ Accepts Medicare132 mi
Optometry
NPI 1841356532
900 S RUM RIVER DR
Princeton, MN 55371
(763) 389-9000
✔ PECOS✔ Accepts Medicare138 mi
Optometry
NPI 1104564269
1459 W SERVICE DR
Winona, MN 55987
(507) 452-6175
✔ PECOS✔ Accepts Medicare141 mi
See all 37 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 1649836016. It was assigned to this organization in the NPPES registry on May 11, 2019. The provider is doing business as Shopko Optical 4059.

Where is Shoptikal LLC located?

Shoptikal LLC is located at 1023 E Blue Earth Ave, Fairmont, MN 56031. The listed phone number is (507) 238-9490.

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), 37 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Shoptikal LLC accept?

Health plans from Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana and Sanford Health Plan 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.