Radiant Eyes LLC
NPI 1679316996ActiveOrganization· Optometrist· Sussex, WI
Optometrist in Sussex, Wisconsin, registered in NPPES in June 2024. The authorized official on file is Nicole Shirley Avgoulas, OD, Optometrist. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1679316996 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 14, 2024 |
| Last updated in NPPES | Jul 13, 2024 |
| Certified by provider | Jul 13, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist Primary | 152W00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (WI) |
|---|
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