Individual provider Active NPI

Matthew David Pullano, PT

  • Physical Therapist
  • Greenville, SC
National Provider Identifier
1619040425
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10183 Issued in SC
Practice address
310 Mills Ave Ste 202
Greenville, SC 29605-4063
Phone
(864) 202-6259
Fax
(864) 509-6641
NPI assigned
Nov 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 017307-1 NY
Physical Therapist 225100000X 10183 SC Primary

Addresses

Primary practice location

310 Mills Ave Ste 202
Greenville, SC 29605-4063

Mailing address

3125 E Main St
Endwell, NY 13760-5958
Phone (607) 748-7369

Other practice location 1

3125 E Main St
Endwell, NY 13760-5958
Phone (607) 748-7369

Other identifiers 6

IdentifierTypeStateIssuer
200486570OtherNYCOMP, RMSCO, CIGNA
5392510OtherNYAETNA
816782OtherNYGHI & MPN
10035643-J508OtherNYCDPHP
438500OtherNYMVP
000021582OtherNYBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040526000093 NY Practitioner - Physical Therapist in Private Practice 4183615610 Reassigns benefits to 1 organization
I20200824000676 SC Practitioner - Physical Therapist in Private Practice 4183615610 Practice locations: Greenville, SC

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pullano Physical Therapy PLLCGroup PAC ID 2567453087, 5 clinicians

Practice addresses (Care Compare)

310 Mills Ave
Suite 202
Greenville, SC 29605-4063
Phone (864) 202-6259

3125 E Main St
Endwell, NY 13760-5958
Phone (607) 748-7369

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
017307NYMDClinical Psychologist
10183SCMDPhysical Therapist
017307-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pullano Physical Therapy, PLLC Physical Therapist CurrentSince Jan 1, 2016 Accepting new patients

Locations

310 Mills Ave
Ste 202
Greenville, SC 29605
Phone (864) 202-6259

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": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1619040425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 E MAIN ST",
            "city": "ENDWELL",
            "state": "NY",
            "postal_code": "137605958",
            "telephone_number": "607-748-7369",
            "fax_number": "607-748-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 MILLS AVE STE 202",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054063",
            "telephone_number": "864-202-6259",
            "fax_number": "864-509-6641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3125 E Main St",
            "address_purpose": "LOCATION",
            "city": "Endwell",
            "state": "NY",
            "postal_code": "137605958",
            "country_code": "US",
            "telephone_number": "607-748-7369",
            "fax_number": "607-748-4189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PULLANO",
        "first_name": "MATTHEW",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "017307-1",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "10183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMP, RMSCO, CIGNA",
            "identifier": "200486570",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5392510",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI & MPN",
            "identifier": "816782",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10035643-J508",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "438500",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000021582",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.