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SHOPKO OPTICAL
NPI 1952356644
Eyewear Supplier in Green Bay, WI

Active since May 23, 2006
700 PILGRIM WAY, GREEN BAY, WI 54304(920) 429-4218(920) 429-5218 Get Directions Write a Review

NPPES record last updated: October 12, 2007. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Shopko Optical NPPES

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

SHOPKO OPTICAL (NPI 1952356644) is a healthcare organization registered as an eyewear supplier in Green Bay, Wisconsin and active in the NPI registry since May 2006. The organization lists Michael J Bettiga, Sr. Vice President Health Services, as its authorized official.

NPPES Registry Identity

NPI1952356644
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHOPKO STORES OPERATING CO. LLC
Location Address700 PILGRIM WAYGreen Bay, WI 54304-5263
Mailing AddressPo Box 19060Green Bay, WI 54307-9060 · (920) 429-4218 · Fax (920) 429-5218
Phone(920) 429-4218
Fax(920) 429-5218
Organization SubpartNo
Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297
Enumeration DateMay 23, 2006
Last NPPES UpdateOctober 12, 2007
✔ NPI 1952356644 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.
700 PILGRIM WAY, Green Bay, WI 54304
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Other Names 1

Doing Business AsShopko Optical

Other Identifiers 1

Medicare PINC04276MN

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

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Shopko Optical, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (3)

Meghan Montreal Steinocker, O.D.
Optometry
NPI 1700174273
5012 S BUR OAK PL
Sioux Falls, SD 57108
(605) 338-3225
✔ PECOS✔ Accepts Medicare439 mi
Michael Johnson, O.D.
Optometry
NPI 1548204191
700 9TH AVE S
Watertown, SD 57201
(605) 882-9424
✔ PECOS✔ Accepts Medicare446 mi
Jason Lorenz, O.D.
Optometry
NPI 1619918216
500 N HWY 281
Aberdeen, SD 57401
(605) 225-7677
✔ PECOS✔ Accepts Medicare516 mi

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 Shopko Stores Operating Co. LLC's NPI number?

The NPI number for Shopko Stores Operating Co. LLC is 1952356644. It was assigned to this organization in the NPPES registry on May 23, 2006. The provider is doing business as Shopko Optical.

Where is Shopko Stores Operating Co. LLC located?

Shopko Stores Operating Co. LLC is located at 700 Pilgrim Way, Green Bay, WI 54304. The listed phone number is (920) 429-4218.

What is Shopko Stores Operating Co. LLC's specialty?

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

Is Shopko Stores Operating Co. LLC enrolled in Medicare?

Yes. Shopko Stores Operating Co. LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Shopko Stores Operating Co. LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Optometry, reassign their Medicare billing to Shopko Stores Operating Co. 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.

When was this NPI record last updated?

The NPPES record for Shopko Stores Operating Co. LLC was last updated on October 12, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.