Individual provider Active NPI

Peter Zatezalo, DPT, OCS, COMT

  • Physical Therapist
  • Arlington, VA
National Provider Identifier
1003292640
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305209513 Issued in VA
Practice address
1033 S Edgewood St
Arlington, VA 22204-4813
Phone
(703) 289-0389
NPI assigned
Aug 5, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT200001383 DC
Physical Therapist 225100000X 2305209513 VA Primary
Physical Therapist 225100000X 050291 NY

Addresses

Primary practice location

1033 S Edgewood St
Arlington, VA 22204-4813

Mailing address

2726 Gallows Rd Apt 804
Vienna, VA 22180-7149

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240409001236 NY Practitioner - Physical Therapist in Private Practice 4789011024 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

973 Fulton St
Brooklyn, NY 11238-2346
Phone (718) 230-1180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT200001383DCMDPhysical Therapist
050291NYMDPhysical Therapist
2305209513VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC CurrentSince Apr 1, 2024 Accepting new patients
Sports Therapy and Rehabilitation,Inc Physical Therapist CurrentSince Jul 28, 2022 Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path Physical Therapist CurrentSince Apr 1, 2024 Accepting new patients
Sports Therapy and Rehabilitation LLC Physical Therapist CurrentSince Jul 28, 2022 Accepting new patients

Locations

1112 16th St NW
Ste 200
Washington, DC 20036
Phone (202) 223-1737

973 Fulton St
Brooklyn, NY 11238
Phone (718) 230-1180

550 Mamaroneck Ave
Ste 104
Harrison, NY 10528
Phone (914) 777-3737

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1438732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1003292640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2726 GALLOWS RD APT 804",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221807149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 S EDGEWOOD ST",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222044813",
            "telephone_number": "703-289-0389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZATEZALO",
        "first_name": "PETER",
        "credential": "DPT, OCS, COMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-05",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DC",
            "license": "PT200001383",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305209513",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "050291",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; 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.