Jack Komro, DO
Jack Komro, DO is an Ophthalmic Plastic and Reconstructive Surgery Physician in Green Bay, WI, registered under NPI 1134700719. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty.
Getting there
The practice address on file is 1087 W MASON ST, Green Bay, WI 54303. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| V6616 | TX | Ophthalmology Physician |
| 82077-21 | WI | Ophthalmic Plastic and Reconstructive… primary |
Licences are recorded in 2 states: TX, WI. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.
- Status
- Approved
- Provider type
- Practitioner - Ophthalmology
- PAC ID
- 1557770690
- Enrollment ID
- I20250516002164
Medicare enrolment is recorded as approved under the provider type Practitioner - Ophthalmology. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
Licensed in 2 states
This provider holds licences in 2 states: Texas and Wisconsin. The practice address on file is in Green Bay, WI, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.
- Licence
- 82077-21
- Specialty
- Ophthalmic Plastic and Reconstructive…
Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.
What Ophthalmic Plastic and Reconstructive Surgery covers
A physician who specializes in oculofacial plastic and reconstructive surgery. This subspecialty combines orbital and periocular surgery with facial plastic surgery, and includes aesthetic and reconstructive surgery of the face, orbit, eyelid, and lacrimal system. Practitioners evaluate, diagnose and treat conditions involving the eyelids, brows, midface, orbits, lacrimal systems and surrounding and supporting structures of the face and neck. NUCC Health Care Provider Taxonomy, code 207WX0200X
All registered taxonomy codes
This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 207W00000X | Ophthalmology Physician | V6616 | TX | |
| 207WX0200X | Ophthalmic Plastic and Reconstructive Surgery Physician Ophthalmic Plastic and Reconstructive Surgery | 82077-21 | WI | primary |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1134700719 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Apr 15, 2021 |
| Last updated | Jul 29, 2026 |
| Status | Active |
| Sole proprietor | No |
| Gender | Male |
| Credential | DO |
| Practice address |
1087 W MASON ST Green Bay, WI 54303 (920) 499-3102 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 1 | 3 | 4 | 7 | 0 | 0 | 7 | 1 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 1 | 6 | 4 | 5 | 0 | 0 | 7 | 2 |
Sum = 51 · next multiple of 10 = 60 · check digit = 9 · actual last digit = 9
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.