Nicholas Pucillo, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

006671 Issued in KY

Practice address

4611 Outer Loop
Louisville, KY 40219-3970

Phone

(502) 625-6233

Fax

(502) 625-6234

NPI assigned

Aug 7, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY, IN2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Agilitas USA, IncGroup PAC ID 3375454648, 812 clinicians

Benchmark Physical Therapy of Ky LLCGroup PAC ID 0042577579, 55 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Agilitas USA Inc

  • Physical Therapy Clinic/Center
  • Hixson, TN
  • NPI 1962417444

  IN, KY, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Benchmark Physical Therapy of Ky LLC

  • Physical Therapist
  • Chattanooga, TN
  • NPI 1043734221

  KY

  Medicare reassignment Care Compare group NPD
• Results-Ast JV, LLC

  • Physical Therapist
  • Franklin, TN
  • NPI 1780291948

  KY

  Medicare reassignment NPD
• Drayer Physical Therapy Kentucky LLC

  • Physical Therapist
  • Lexington, KY
  • NPI 1821430257
  Medicare reassignment
• Drayer Physical Therapy Kentucky LLC

  • Physical Therapist
  • Richmond, KY
  • NPI 1003258443
  NPD
• Drayer Physical Therapy Kentucky LLC

  • Physical Therapist
  • Winchester, KY
  • NPI 1639511074
  NPD
• Agilitas USA, Inc

  • Physical Therapy Clinic/Center
  • Chattanooga, TN
  • NPI 1518695436

  Physical Therapist

  NPD
• Agilitas USA Inc

  • Physical Therapy Clinic/Center
  • Louisville, KY
  • NPI 1609117811
  NPD (past)

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

{
    "created_epoch": "1438905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568937600000",
    "number": "1043696404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 CRESCENT CENTRE DR STE 300",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370677285",
            "telephone_number": "616-373-1350",
            "fax_number": "615-221-9054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4611 OUTER LOOP",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402193970",
            "telephone_number": "502-625-6233",
            "fax_number": "502-625-6234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCILLO",
        "first_name": "NICHOLAS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-07",
        "last_updated": "2019-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "006671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• PT Pros, Inc.
• PT Solutions, LLC
• Publix Super Markets, Inc.
• Publix Super Markets, Inc.
• Publix Super Markets, Inc.
• Puckett Ullom Inc
• Brieanna Puckett
• Eleanor H Puckett, ARNP
• James Cole Puckett, PHARMD
• Jennifer Puckett

• Physical Therapist in Louisville, KY
• Providers in Louisville, KY by specialty
• Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2019; 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.