ALEXANDRA SMITH (OD) – Optometrist, NPI 1104676667

ALEXANDRA SMITH (OD) is a healthcare provider. based in Fort collins, Colorado. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. OPT.0004022 (CO). The NPI Number for ALEXANDRA SMITH (OD) is 1104676667

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
ALEXANDRA SMITH (OD)
NPI
1104676667
Phone
Not provided
Address
1725 E PROSPECT RD
Enumeration Date
26 March 2024
Last Update Date
22 September 2025

Doctor Profile

Medical School Name
SOUTHERN COLLEGE OF OPTOMETRY
Secondary Phone
9706633262
Graduation Year
2024 (2 years ago)
PAC ID
1153838057
Group Practice PAC ID
5496644841
Professional Enrollment ID
I20250725003706
Address ID
CO805389372LO6125XDRXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness85
Years active:2State licenses:1Digital endpointsOther names

851 OPTOMETRY in CO

Provider Addresses for ALEXANDRA SMITH (OD)

  • 1725 E PROSPECT RD

    FORT COLLINS, CO 805251307

    Phone:

    Type: Mailing

  • 6125 SKY POND DR STE 160

    LOVELAND, CO 805389372

    Phone: (970) 221-2222

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-07-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250725003706IOptometryCOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 80525)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5496644841View full group profile
NameSpecialtyState
O P H T H A L M O L O G YCO
O P H T H A L M O L O G YCO
Certified Registered Nurse Anesthetist (Crna)CO
Certified Registered Nurse Anesthetist (Crna)CO
O P T O M E T R YCO
O P H T H A L M O L O G YCO
O P T O M E T R YCO
O P H T H A L M O L O G YCO
O P H T H A L M O L O G YCO
O P H T H A L M O L O G YWI

Reviews

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Frequently asked questions

Does ALEXANDRA SMITH (OD) have a public NPI I can cite?
Public records show ALEXANDRA SMITH (OD) under NPI 1104676667.
Is ALEXANDRA SMITH (OD)'s NPI status active today?
Active status means ALEXANDRA SMITH (OD)'s NPI record is not deactivated in the public file.
How should patients interpret ALEXANDRA SMITH (OD)'s specialty?
The extract shows Optometrist for ALEXANDRA SMITH (OD). Clinical services aligned with this taxonomy classification.
What geographic area is tied to ALEXANDRA SMITH (OD)?
ALEXANDRA SMITH (OD) is associated with Fort Collins, Colorado in the same public data insurers reference.
Who maintains ALEXANDRA SMITH (OD)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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