Individual provider Active NPI

Alexa Treguboff

  • Physical Therapist
  • Glendale, AZ
National Provider Identifier
1396551933
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
033935 Issued in AZ
Practice address
6630 W Cactus Rd
Glendale, AZ 85304-1600
Phone
(623) 469-5811
NPI assigned
Dec 9, 2024
Last updated
Dec 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 033935 AZ Primary

Addresses

Primary practice location

6630 W Cactus Rd
Glendale, AZ 85304-1600

Mailing address

10591 W Alex Ave
Peoria, AZ 85382-0507
Phone (623) 694-6098

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241223003231 AZ Practitioner - Physical Therapist in Private Practice 5092242446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
360 Physical Therapy LLCGroup PAC ID 1355237645, 87 clinicians

Practice addresses (Care Compare)

6630 W Cactus Rd
Suite B112
Glendale, AZ 85304-1662
Phone (623) 469-5811

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
033935AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
360 Physical Therapy LLC Physical Therapist CurrentSince Dec 23, 2024 Accepting new patients
360 Physical Therapy LLC Physical Therapist CurrentSince Dec 23, 2024 Accepting new patients
360 Physical Therapy, LLC Current Accepting new patients

Locations

1076 W Chandler Blvd
Ste 103
Chandler, AZ 85224
Phone 4808211997116

6630 W Cactus Rd
Ste B112
Glendale, AZ 85304
Phone (623) 469-5811

1382 S Cotton Ln
Goodyear, AZ 85338
Phone (520) 438-7090

21083 N John Wayne Pkwy
Ste C104
Maricopa, AZ 85139
Phone (520) 233-7555

11340 W Bell Rd
Ste A101
Surprise, AZ 85378
Phone (623) 226-6644

2600 Dallas Pkwy
Ste 290
Frisco, TX 75034
Phone (945) 260-0010

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1733702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1396551933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10591 W ALEX AVE",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853820507",
            "telephone_number": "623-694-6098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6630 W CACTUS RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853041600",
            "telephone_number": "623-469-5811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREGUBOFF",
        "first_name": "ALEXA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-09",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "033935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.