Individual provider Active NPI

Alexa Sophia Lora, OD

  • Optometrist
  • Fort Pierce, FL
National Provider Identifier
1023904380
Registry record updated Jun 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC6758 Issued in FL
Practice address
4976 S 25TH St
Fort Pierce, FL 34981-5009
Phone
(772) 460-8487
NPI assigned
Jun 14, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC6758 FL Primary

Addresses

Primary practice location

4976 S 25TH St
Fort Pierce, FL 34981-5009

Mailing address

4976 S 25TH St
Fort Pierce, FL 34981-5009
Phone (772) 460-8487

Other practice location 1

2710 SW Port St Lucie Blvd
Port Saint Lucie, FL 34953-2849
Phone (772) 878-1414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251015002018 FL Practitioner - Optometry 5294222097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
William a. Olivos, OD, PAGroup PAC ID 0143422667, 3 clinicians

Practice addresses (Care Compare)

2710 SW Port St Lucie Blvd
Port Saint Lucie, FL 34953-2849
Phone (772) 878-1414

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
William a. Olivos, OD, PA CurrentSince Jul 20, 2025 Accepting new patients

Locations

4976 S 25th St
Fort Pierce, FL 34981
Phone (772) 460-8487

2710 SW Port St Lucie Blvd
Port St Lucie, FL 34953
Phone (772) 446-1271

Networks

  • FL PPO

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1749859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749859200000",
    "number": "1023904380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4976 S 25TH ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349815009",
            "telephone_number": "772-460-8487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4976 S 25TH ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349815009",
            "telephone_number": "772-460-8487"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2710 SW Port St Lucie Blvd",
            "address_purpose": "LOCATION",
            "city": "Port Saint Lucie",
            "state": "FL",
            "postal_code": "349532849",
            "country_code": "US",
            "telephone_number": "772-878-1414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LORA",
        "first_name": "ALEXA",
        "middle_name": "SOPHIA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-14",
        "last_updated": "2025-06-14",
        "certification_date": "2025-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC6758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

Verify at the official NPI Registry.