Matthew Pulisic, DPT MS OCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305003929 Issued in VA

Practice address

203 N Washington Hwy
Ashland, VA 23005

Phone

(804) 340-1193

Fax

(804) 340-1930

NPI assigned

Mar 14, 2006

Last updated

Oct 16, 2019By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ashland PT Associates, LLCGroup PAC ID 2264932342, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ashland PT Associates LLC

  • Physical Therapy Clinic/Center
  • Ashland, VA
  • NPI 1902606445

  Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1245209188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 N WASHINGTON HWY",
            "city": "ASHLAND",
            "state": "VA",
            "postal_code": "230051623",
            "telephone_number": "804-798-1112",
            "fax_number": "804-798-1171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 N WASHINGTON HWY",
            "city": "ASHLAND",
            "state": "VA",
            "postal_code": "23005",
            "telephone_number": "804-340-1193",
            "fax_number": "804-340-1930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULISIC",
        "first_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "DPT  MS  OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305003929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010330483",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8941653",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory Podolak
• Edward Spencer Powers, LPC, ATR-BC
• Angela Marie Pressley
• Jessica Elizabeth Price
• Jennifer M Pulisic
• Janet E Purcell-Baserap, MS, OTR/L
• Brooke Mackenzie Purcell
• Kemelee M Puryear, RN
• Ronald Puryear
• Alejandro Quiroga

• Physical Therapist in Ashland, VA
• Providers in Ashland, VA by specialty
• Physical Therapist in Virginia

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