ALEX MARTYNENKO – Physical Medicine & Rehabilitation Physician, NPI 1124833629

ALEX MARTYNENKO is a healthcare provider. based in Colleyville, Texas. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold a License No. 1404068 (TX). The NPI Number for ALEX MARTYNENKO is 1124833629

Main info

Male
2 Years Of Experience
Accepts Medicare Assignment
Name
ALEX MARTYNENKO
NPI
1124833629
Phone
(817) 498-3919
Address
1109 CHURCH ST
Enumeration Date
11 February 2025
Last Update Date
11 February 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8174983919
Graduation Year
2024 (2 years ago)
PAC ID
8325569072
Group Practice PAC ID
1153315791
Professional Enrollment ID
I20250311000132
Address ID
TX760345849CO1109XSTXX300
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

5,353 PHYSICAL THERAPIST IN PRIVATE PRACTICE in TX

Provider Addresses for ALEX MARTYNENKO

  • 1109 CHURCH ST

    COLLEYVILLE, TX 760345849

    Phone: (817) 498-3919

    Mailing address matches the actual address.

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: 2025-03-11

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
I20250311000132IPhysical Therapist In Private PracticeTXTBD

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 76034)

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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: 1153315791View full group profile
NameSpecialtyState
-TX
-TX
Physical Therapist In Private PracticeTX
Occupational Therapist In Private PracticeTX
Physical Therapist In Private PracticeTX
Occupational Therapist In Private PracticeTX
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeTX
Occupational Therapist In Private PracticeIN
Physical Therapist In Private PracticeAZ

Reviews

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Frequently asked questions

Where can patients find ALEX MARTYNENKO's NPI?
You can confirm ALEX MARTYNENKO with NPI 1124833629; it appears in the national provider directory.
Is ALEX MARTYNENKO currently active in the NPI registry?
CMS-published data lists ALEX MARTYNENKO as an active registrant.
What does ALEX MARTYNENKO treat or focus on?
Patients typically see ALEX MARTYNENKO under the specialty Physical Medicine & Rehabilitation Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for ALEX MARTYNENKO?
The page summarizes Colleyville, Texas for ALEX MARTYNENKO; expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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