Andrew John Petulla, P.T.

Primary specialty

SpecialistTaxonomy code 174400000X

License

PT15558 Issued in CA

Practice address

2048 Lincoln Ave
San Jose, CA 95125-3449

Phone

(408) 448-1677

Fax

(408) 448-7060

NPI assigned

Jul 28, 2006

Sex

Male

Sole proprietor

Yes

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 CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1988

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.49 of 100Reported as individual

Quality

94.85

Improvement activities

40

Cost

71.82

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063426807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2048 LINCOLN AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951253449",
            "telephone_number": "408-448-1677",
            "fax_number": "408-448-7060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2048 LINCOLN AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951253449",
            "telephone_number": "408-448-1677",
            "fax_number": "408-448-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETULLA",
        "first_name": "ANDREW",
        "middle_name": "JOHN",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "PT15558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle Pettit, M.A.
• Mahleiah Amele Pettus-Johnson
• Manju Simha Petty, LMFT
• Steve Petty, MD
• Yoko Petty
• Petzoldt Memorial Hand Physical Therapy
• Thomas D Petzoldt, O.T.
• Elena Pezzini, PHD
• Loretta Mary Pfaff, M.F.T.
• Madison Pfaff, RBT

• Specialist in San Jose, CA
• Providers in San Jose, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.