Individual provider Active NPI

Lori Ann Sportelli, OD

  • Optometrist
  • Salisbury, MD
National Provider Identifier
1417035981
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA1569 Issued in MD
Practice address
2657 N Salisbury Blvd Ste 104
Salisbury, MD 21801-2184
Phone
(410) 742-6148
Fax
(410) 219-3654
NPI assigned
Nov 1, 2006
Last updated
Aug 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 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 TA1569 MD Primary

Addresses

Primary practice location

2657 N Salisbury Blvd Ste 104
Salisbury, MD 21801-2184

Mailing address

814 S Ellwood Ave
Baltimore, MD 21224-3951
Phone (410) 284-2352

Other practice location 1

8201 Philadelphia Rd
Rosedale, MD 21237-2832
Phone (410) 866-2022

Other identifiers 1

IdentifierTypeStateIssuer
401431600MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20111122000188 MD Practitioner - Optometry 2668646084 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peninsula Eye Center PAGroup PAC ID 0244314235, 5 clinicians
Myeyedr Optometry of Maryland LLCGroup PAC ID 6002037629, 121 clinicians

Practice addresses (Care Compare)

101 Milford St
Salisbury, MD 21804-6952
Phone 4107499290105

2657 N Salisbury Blvd
Suite 104
Salisbury, MD 21801-2184
Phone (410) 742-6148

2936 Festival Way
Suite 409a
Waldorf, MD 20601-2957
Phone (301) 710-6919

Merit-based Incentive Payment System (MIPS)

Final score
93.43 of 100Reported as group
Quality
100
Improvement activities
40
Cost
78.11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Peninsula Eye Center PA CurrentSince Oct 1, 2024 Accepting new patients
Accurate Optical Co of Cambridge Inc Optometrist CurrentSince Mar 1, 2022 Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist CurrentSince Oct 27, 2025 Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist CurrentSince Oct 27, 2025 Accepting new patients

Locations

6306 York Rd
#1-2
Baltimore, MD 21212
Phone (443) 863-5206

314 Franklin Ave
Ste 101
Berlin, MD 21811
Phone (410) 641-3954

2711 Ocean Gtwy
Ste B
Cambridge, MD 21613
Phone (410) 228-1110

101 Milford St
Salisbury, MD 21804
Phone (410) 749-9290

2657 N Salisbury Blvd
Ste 104
Salisbury, MD 21801
Phone (410) 742-6148

2936 Festival Way
Ste 409A
Waldorf, MD 20601
Phone (301) 710-6919

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Interoperability endpoints

  • Direct secure messaging: lori.sportelli.p1@direct.katzeneye.nextgenshare.com
  • Direct secure messaging: lsportelli@peninsula.intellechartdirect.net

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756425600000",
    "number": "1417035981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 S ELLWOOD AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212243951",
            "telephone_number": "410-284-2352",
            "fax_number": "410-284-3796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2657 N SALISBURY BLVD STE 104",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218012184",
            "telephone_number": "410-742-6148",
            "fax_number": "410-219-3654"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8201 Philadelphia Rd",
            "address_purpose": "LOCATION",
            "city": "Rosedale",
            "state": "MD",
            "postal_code": "212372832",
            "country_code": "US",
            "telephone_number": "410-866-2022",
            "fax_number": "410-866-2031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPORTELLI",
        "first_name": "LORI",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "401431600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

Verify at the official NPI Registry.