DR. LORI LEIGH RUSSO (O.D.) – Optometrist, NPI 1700971637

DR. LORI LEIGH RUSSO (O.D.) is a healthcare provider. based in Fort worth, Texas. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 6416TG (TX). The NPI Number for DR. LORI LEIGH RUSSO (O.D.) is 1700971637

Main info

Female
23 Years Of Experience
Accepts Medicare Assignment
Name
DR. LORI LEIGH RUSSO (O.D.)
NPI
1700971637
Phone
(817) 750-2233
Address
7201 BOAT CLUB RD
Enumeration Date
4 October 2006
Last Update Date
2 March 2026

Doctor Profile

Medical School Name
UNIVERSITY OF HOUSTON - COLLEGE OF OPTOMETRY
Secondary Phone
8175737153
Graduation Year
2003 (23 years ago)
PAC ID
3779485768
Group Practice PAC ID
1052224730
Professional Enrollment ID
I20040121000690
Address ID
TX760497432GR4000X377X500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness85
Years active:19State licenses:1Digital endpointsOther names

3,128 OPTOMETRY in TX

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Provider Addresses for DR. LORI LEIGH RUSSO (O.D.)

  • 7201, Boat Club Road, Fort Worth, Tarrant County, Texas, 76179, United States

    FORT WORTH, TX 761794555

    Phone: (817) 750-2233

    Fax: (817) 750-2266

    Type: Location

  • 4000 E US HIGHWAY 377

    GRANBURY, TX 760497432

    Phone: (817) 573-7153

    Fax: (817) 573-5640

    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: 2004-01-21

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
I20040121000690IOptometryTXTBD

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 76179)

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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: 1052224730View full group profile
NameSpecialtyState
O P T O M E T R YTX
O P T O M E T R YTX
O P T O M E T R YOK
O P T O M E T R YTX

Reviews

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Frequently asked questions

Can I use this page to confirm DR. LORI LEIGH RUSSO (O.D.)'s NPI?
Yes. DR. LORI LEIGH RUSSO (O.D.) is listed with NPI 1700971637 in the public NPI dataset.
Does the file indicate DR. LORI LEIGH RUSSO (O.D.) is practicing under active NPI?
Directory data currently reports DR. LORI LEIGH RUSSO (O.D.) as active.
What is DR. LORI LEIGH RUSSO (O.D.)'s primary classification?
Optometrist is the headline specialty for DR. LORI LEIGH RUSSO (O.D.) here. Clinical services aligned with this taxonomy classification.
Where is DR. LORI LEIGH RUSSO (O.D.) based?
DR. LORI LEIGH RUSSO (O.D.) is tied to Fort Worth, Texas in the data we show; additional addresses may exist on the full record.
Why does DR. LORI LEIGH RUSSO (O.D.) have multiple addresses?
4 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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