ALEX LAGRUTTA (PT) – Physical Therapist, NPI 1720807423

ALEX LAGRUTTA (PT) is a healthcare provider. based in Nixa, Missouri. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. PT5492 (AR). The NPI Number for ALEX LAGRUTTA (PT) is 1720807423

Main info

Male
2 Years Of Experience
Accepts Medicare Assignment
Name
ALEX LAGRUTTA (PT)
NPI
1720807423
Phone
(417) 300-9965
Address
1148 W RIVERDALE DR
Enumeration Date
9 October 2024
Last Update Date
9 October 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4793401100
Graduation Year
2024 (2 years ago)
PAC ID
0244766848
Group Practice PAC ID
5395032882
Professional Enrollment ID
I20241205003447
Address ID
AR727046541FA3399XDRXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

835 PHYSICAL THERAPIST IN PRIVATE PRACTICE in AR

Provider Addresses for ALEX LAGRUTTA (PT)

  • 1148 W RIVERDALE DR

    NIXA, MO 657148255

    Phone: (417) 300-9965

    Type: Mailing

  • 3399 BLACK FOREST DR STE 3

    FAYETTEVILLE, AR 727046541

    Phone: (479) 435-6712

    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: 2024-12-05

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
I20241205003447IPhysical Therapist In Private PracticeARTBD

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 65714)

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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: 5395032882View full group profile
NameSpecialtyState
-MO
Physical Therapist In Private PracticeOK
Physical Therapist In Private PracticeAR
Physical Therapist In Private PracticeAR
Physical Therapist In Private PracticeAR
Physical Therapist In Private PracticeAR
Physical Therapist In Private PracticeMO
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeMO
Physical Therapist In Private PracticeAR

Reviews

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Frequently asked questions

What is the standard ID for ALEX LAGRUTTA (PT) in the U.S.?
In the U.S., ALEX LAGRUTTA (PT) is identified by NPI 1720807423.
Is ALEX LAGRUTTA (PT)'s NPI status active today?
Active status means ALEX LAGRUTTA (PT)'s NPI record is not deactivated in the public file.
What services align with ALEX LAGRUTTA (PT)'s listing?
ALEX LAGRUTTA (PT)'s public classification highlights Physical Therapist. Clinical services aligned with this taxonomy classification.
What city is tied to ALEX LAGRUTTA (PT)?
The directory associates ALEX LAGRUTTA (PT) with Nixa, Missouri. Check all listed addresses for suites or satellite offices.
Can I export ALEX LAGRUTTA (PT)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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