Active NPI
Virginia Mottla, PT, DPT, CSCS
- Physical Therapist
- New York, NY
National Provider Identifier
1285595249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 055269
- Practice address
- 1317 3Rd Ave FL 9
New York, NY 10021-2963 - Phone
- (212) 439-1596
- NPI assigned
- Nov 19, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 055269 | NY | Primary |
Addresses
Primary practice location
1317 3Rd Ave FL 9
New York, NY 10021-2963
Mailing address
3806 20TH Rd
Astoria, NY 11105-1626
Phone (617) 633-4144
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- New York University School of Medicine, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1317 3Rd Ave
FL 9
New York, NY 10021-2963
Phone (212) 439-1596
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 055269 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Evolve Physical Therapy, PLLC | Physical Therapist | Current | Accepting new patients |
Locations
1317 3rd Ave
Fl 9
New York, NY 10021
Phone (212) 439-1596
Organizations & group practices 1
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": "1763510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763510400000",
"number": "1285595249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3806 20TH RD",
"city": "ASTORIA",
"state": "NY",
"postal_code": "111051626",
"telephone_number": "617-633-4144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1317 3RD AVE FL 9",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100212963",
"telephone_number": "212-439-1596"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOTTLA",
"first_name": "VIRGINIA",
"credential": "PT, DPT, CSCS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-11-19",
"last_updated": "2025-11-19",
"certification_date": "2025-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "055269",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.