REX E LUTTRELL (M.D.) – Surgery Physician, NPI 1477559680
Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for REX E LUTTRELL (M.D.)
PO BOX 5209
JACKSONVILLE, AR 720785209
Phone: (501) 978-4343
Fax: (501) 975-8995
Type: Mailing
1300, Braden Street, Jacksonville, Pulaski County, Arkansas, 72076, United States
POD B
JACKSONVILLE, AR 720763719
Phone: (501) 978-4343
Fax: (501) 975-8995
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 16 Open Payments records for all available years, with a total value of $749.
Total Amount is formed as General ($749) + Research ($0) + Ownership ($0) = $749.
Last reported payment date: 2024-09-20 • Largest payer in this snapshot: W. L. Gore & Associates, Inc. ($383).
Total Amount
$749
General + Research + Ownership
Payments
16
Total payment records
General Amount
$749
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| W. L. Gore & Associates, Inc. | $383 |
| Apollo Endosurgery US Inc | $129 |
| Ethicon US, LLC | $60 |
| KCI USA, Inc. | $33 |
| Innovation Technologies Inc | $30 |
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: 2005-12-06
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20051206000952 | I | General Surgery | AR | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 194 | 85 | $0 |
| 43999 | Other procedure on stomach | 39 | 19 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 33 | 33 | $0 |
| 74220 | Single contrast x-ray of esophagus | 32 | 19 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 20 | 18 | $0 |
Insurance plans in this area (ZIP 72078)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| GENERAL SURGERY | AR | 11042 | Removal of skin and tissue first 20 sq cm or less | 165 | 65 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | AR | |
| Cardiovascular Disease (Cardiology), Internal Medicine | AR | |
| - | AR | |
| - | AR | |
| Family Practice | AR | |
| Internal Medicine | AR | |
| Physician Assistant | AR | |
| Nurse Practitioner | AR | |
| Internal Medicine, Cardiovascular Disease (Cardiology) | AR | |
| Nurse Practitioner | AR |
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