SHOPKO OPTICAL 4005
NPI 1871138073
Eyewear Supplier in Depere, WI

Active since November 12, 2019
723 MAIN AVE, DEPERE, WI 54115(920) 336-3390 Get Directions Write a Review

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

About Shopko Optical 4005 NPPES

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

SHOPKO OPTICAL 4005 (NPI 1871138073) is a healthcare organization registered as an eyewear supplier in Depere, Wisconsin and active in the NPI registry since November 2019. The organization lists Russell Steinhorst, Evp & Cfo, as its authorized official.

NPPES Registry Identity

NPI1871138073
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPTIKAL LLC
Location Address723 MAIN AVEDepere, WI 54115
Mailing AddressPo Box 19060Green Bay, WI 54307-9060
Organization SubpartNo
Authorized OfficialRussell SteinhorstEvp & Cfo · (920) 429-7489
Enumeration DateNovember 12, 2019
Last NPPES UpdateNovember 29, 2024
NPPES CertifiedNovember 29, 2024
✔ NPI 1871138073 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
723 MAIN AVE, Depere, WI 54115

Other Names 1

Doing Business AsShopko Optical 4005

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 4005 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 4005, 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 1952392003
723 MAIN AVE
De Pere, WI 54115
(920) 336-3390
✔ PECOSSame address
Optometry
NPI 1457843161
230 N WISCONSIN ST
De Pere, WI 54115
(920) 336-3390
✔ PECOS✔ Accepts Medicare1.1 mi
Optometry
NPI 1093767931
230 N WISCONSIN ST
De Pere, WI 54115
(920) 336-3390
✔ PECOS✔ Accepts Medicare1.1 mi
Optometry
NPI 1316674625
2621 S ONEIDA ST
Green Bay, WI 54304
(920) 499-3511
✔ PECOS✔ Accepts Medicare2.1 mi
Optometry
NPI 1205090990
700 PILGRIM WAY
Green Bay, WI 54304
(920) 733-3846
✔ PECOS✔ Accepts Medicare2.6 mi
1515 6TH ST
Green Bay, WI 54304
(920) 499-2147
✔ PECOS✔ Accepts Medicare4.9 mi
Optometry
NPI 1003867961
216 S MILITARY AVE
Green Bay, WI 54303
(920) 494-3384
✔ PECOS✔ Accepts Medicare5.8 mi
Optometry
NPI 1003838129
2793 LINEVILLE RD
Green Bay, WI 54313
(920) 496-4700
✔ PECOS✔ Accepts Medicare9.8 mi
Optometry
NPI 1396031951
2485 LINEVILLE RD STE 102
Green Bay, WI 54313
(920) 857-3700
✔ PECOS✔ Accepts Medicare9.8 mi
Optometry
NPI 1629636105
2314 LINEVILLE RD STE 104
Suamico, WI 54313
(920) 434-5845
✔ PECOS✔ Accepts Medicare9.9 mi
Optometry
NPI 1023105772
1301 E NORTHLAND AVE SUITE A
Appleton, WI 54911
(920) 734-8714
✔ PECOS✔ Accepts Medicare19 mi
Optometry
NPI 1396714812
3329 N RICHMOND ST
Appleton, WI 54911
(920) 380-2715
✔ PECOS✔ Accepts Medicare20 mi
Optometry
NPI 1417908955
1000 W NORTHLAND AVE
Appleton, WI 54914
(920) 731-4511
✔ PECOS✔ Accepts Medicare20 mi
Optometry
NPI 1336435445
1033 W NORTHLAND AVE STE B
Appleton, WI 54914
(920) 731-4511
✔ PECOS✔ Accepts Medicare20 mi
Optometry
NPI 1881647030
1640 APPLETON RD
Menasha, WI 54952
(920) 725-3752
✔ PECOS✔ Accepts Medicare23 mi
Optometry
NPI 1114074416
4301 W WISCONSIN AVE
Appleton, WI 54913
(920) 730-8770
✔ PECOS✔ Accepts Medicare23 mi
Optometry
NPI 1073207445
1255 APPLETON RD
Menasha, WI 54952
(920) 722-6872
✔ PECOS✔ Accepts Medicare23 mi
Optometry
NPI 1407966658
955 MUTUAL WAY
Appleton, WI 54913
(920) 954-6600
✔ PECOS✔ Accepts Medicare23 mi
Optometry
NPI 1912105255
1155 W WINNECONNE AVE
Neenah, WI 54956
(920) 722-1541
✔ PECOS✔ Accepts Medicare28 mi
Optometry
NPI 1285326975
4550 CALUMET AVE
Manitowoc, WI 54220
(920) 683-2244
✔ PECOS✔ Accepts Medicare32 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 1871138073. It was assigned to this organization in the NPPES registry on November 12, 2019. The provider is doing business as Shopko Optical 4005.

Where is Shoptikal LLC located?

Shoptikal LLC is located at 723 Main Ave, Depere, WI 54115. The listed phone number is (920) 336-3390.

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, HealthPartners, Quartz and Security 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.