ALEXANDRA ACQUAVIVA MD
NPI 1336896364
Family Medicine in Fort Leonard Wood, MO

Q: What is Alexandra Acquaviva's NPI number?

The NPI number for Alexandra Acquaviva is 1336896364. It was assigned to this individual provider in the NPPES registry on March 9, 2022. The provider is also known as Alexandra Berthiaume MD.

Q: What is Alexandra Acquaviva's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since March 09, 2022PECOS Enrolled

4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473(573) 596-0417 Get Directions Write a Review

NPPES record last updated: October 2, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 14, 2023, Dec 4, 2023, Mar 9, 2022 (3 updates tracked since 2022).

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About Alexandra Acquaviva Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALEXANDRA ACQUAVIVA MD (NPI 1336896364) is an individual family medicine provider in Fort Leonard Wood, Missouri, licensed in Virginia (0101279768) and active in the NPI registry since March 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1336896364

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameALEXANDRA ACQUAVIVACredential: MD

Location Address4430 MISSOURI AVEFort Leonard Wood, MO 65473-9098

Mailing Address4430 Missouri AveFort Leonard Wood, MO 65473-9098 · (573) 596-0417

Phone(573) 596-0417

Sole ProprietorNo

Enumeration DateMarch 9, 2022

Last NPPES UpdateOctober 2, 20253 updates tracked since enumeration

NPPES CertifiedOctober 2, 2025

✔ NPI 1336896364 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in VA · 0101279768

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

4430 MISSOURI AVE, Fort Leonard Wood, MO 65473

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Other Names 1

Former Name (1)Alexandra Berthiaume Md

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alexandra Acquaviva Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 65473 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.64 typical visit price

range $52.28 – $161.24

Typical copayment $20.41 (range $13.07 – $40.31)

Most-billed visit code 99203

Established Patient

$93.24 typical visit price

range $16.30 – $131.05

Typical copayment $23.31 (range $4.07 – $32.76)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. JON-MARC THIBODEAU PA-C

Physician Assistant