Individual provider Active NPI

Leticia Alexandra Rousso, O.D.

  • Optometrist
  • Boca Raton, FL
National Provider Identifier
1083099725
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC5090 Issued in FL
Practice address
9960 Central Park Blvd N Ste 450
Boca Raton, FL 33428-1760
Phone
(561) 642-1000
Fax
(561) 804-5463
NPI assigned
Jul 23, 2015
Last updated
Jul 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC5090 FL Primary

Addresses

Primary practice location

9960 Central Park Blvd N Ste 450
Boca Raton, FL 33428-1760

Mailing address

1515 N Flagler Dr Ste 101
West Palm Beach, FL 33401-3429
Phone (561) 659-1270

Other practice location 1

3200 S University Dr
Terry Building 1402
Davie, FL 33328-2018
Phone (954) 262-1402

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
I20151015001916 FL Practitioner - Optometry 5193034015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
72.47 of 100Reported as group
Quality
62.45
Improvement activities
40
Cost
73.28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nova Southeastern University, Inc Optometrist Current Accepting new patients
Nova Southeastern University, Inc. Optometrist CurrentSince Jul 1, 2015 Accepting new patients
Nova Southeastern University Inc. CurrentSince Jul 1, 2015 Accepting new patients
Nova Southeastern University, Inc Optometrist PastSince Jul 16, 2023 Accepting new patients
Nova Southeastern University, Inc Past Accepting new patients

Locations

3200 S University Dr
Bldg 2ND
Davie, FL 33328
Phone (954) 262-4200

3200 S University Dr
Bldg 1402
Davie, FL 33328
Phone (954) 262-1402

650 N Andrews Ave
Ft Lauderdale, FL 33311
Phone (954) 463-4213

1750 NE 167th St
North Miami Beach, FL 33162
Phone (305) 949-4000

819 NE 26th St
Bldg C
Wilton Manors, FL 33305

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1437609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1083099725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 N FLAGLER DR STE 101",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334013429",
            "telephone_number": "561-659-1270",
            "fax_number": "561-804-5463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9960 CENTRAL PARK BLVD N STE 450",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334281760",
            "telephone_number": "561-642-1000",
            "fax_number": "561-804-5463"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3200 S University Dr",
            "address_2": "Terry Building 1402",
            "address_purpose": "LOCATION",
            "city": "Davie",
            "state": "FL",
            "postal_code": "333282018",
            "country_code": "US",
            "telephone_number": "954-262-1402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROUSSO",
        "first_name": "LETICIA",
        "middle_name": "ALEXANDRA",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-23",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.