Petya Djoubrailov, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305208035 Issued in VA

Practice address

501 Church St NE Ste 115
Vienna, VA 22180-4734

Phone

(703) 679-8078

NPI assigned

Jul 25, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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 and National Provider Directory roles.

• Deluxe Physical Therapy LLC

  • Physical Therapist
  • Vienna, VA
  • NPI 1700503067

  DC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1374710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1801238316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 173",
            "city": "OAKTON",
            "state": "VA",
            "postal_code": "221240173",
            "telephone_number": "703-679-8078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 CHURCH ST NE STE 115",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804734",
            "telephone_number": "703-679-8078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DJOUBRAILOV",
        "first_name": "PETYA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-25",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "VA",
            "license": "0019008522",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305208035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda Dintiman, M.D.
• Cristina Carmen Dinunzio, PT
• Distinctive Dermatology PLLC
• Robert Elio Divalentin, DDS
• Denise Diver-Laver, O.T.
• DKDC Orthodontics PLLC
• DMV Smile LLC
• John Francis Dobricky III, LCSW
• Nancy Dodds, LMFT
• Damaris Lidia Dolan, MS CCC-SLP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.