Individual provider Active NPI

Ethan Michael Dutka, DPT

  • Physical Therapist
  • Greer, SC
National Provider Identifier
1770435299
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13232 Issued in SC
Practice address
420 The Pkwy Ste D
Greer, SC 29650-5206
Phone
(864) 879-7757
NPI assigned
Feb 10, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 13232 SC Primary

Addresses

Primary practice location

420 The Pkwy Ste D
Greer, SC 29650-5206

Mailing address

215 Edmondston Dr BLDG 116
Piedmont, SC 29673-6423

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260429003780 SC Practitioner - Physical Therapist in Private Practice 3173090800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palmetto Physical Therapy PCGroup PAC ID 5698768653, 3 clinicians

Practice addresses (Care Compare)

420 The Pkwy
Suite D
Greer, SC 29650-5206
Phone (864) 879-7757

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13232SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Physical Therapy PC Physical Therapist CurrentSince Jan 17, 2026 Accepting new patients
Palmetto Physical Therapy Physical Therapist PastSince Jan 17, 2026 Accepting new patients

Locations

420 The Pkwy
Ste D
Greer, SC 29650
Phone (864) 879-7757

Organizations & group practices 2

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": "1770681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1770435299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 EDMONDSTON DR BLDG 116",
            "city": "PIEDMONT",
            "state": "SC",
            "postal_code": "296736423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 THE PKWY STE D",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296505206",
            "telephone_number": "864-879-7757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTKA",
        "first_name": "ETHAN",
        "middle_name": "MICHAEL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-02-10",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "13232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greer, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2026; 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.