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ANDREW JOHN PETULLA P.T.
NPI 1063426807
Specialist in San Jose, CA

Active since July 28, 2006
0/100
CMS Quality Rating
2048 LINCOLN AVE, SAN JOSE, CA 95125(408) 448-1677(408) 448-7060 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Andrew John Petulla P.t. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANDREW JOHN PETULLA P.T. (NPI 1063426807) is an individual specialist in San Jose, California, licensed in California (PT15558) and active in the NPI registry since July 2006. He is a graduate of Other (1988).

NPPES Registry Identity

NPI1063426807
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameANDREW JOHN PETULLACredential: P.T.
Location Address2048 LINCOLN AVESan Jose, CA 95125-3449
Mailing Address2048 Lincoln AveSan Jose, CA 95125-3449 · (408) 448-1677 · Fax (408) 448-7060
Phone(408) 448-1677
Fax(408) 448-7060
Sole ProprietorYes
Medical School CMSOtherGraduated 1988
Enumeration DateJuly 28, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1063426807 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in CA · PT15558
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
2048 LINCOLN AVE, San Jose, CA 95125
Open in Google Maps ↗

Other Identifiers 1

Medicare ID-Type UnspecifiedOPT155580CA · Physical Therapist

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Andrew John Petulla P.t. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6709959075
PECOS Enrollment IDI20080718000626

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes 97110
This therapy involves exercises to boost strength, endurance, flexibility, and range of motion. Each session lasts 15 minutes. The goal is to improve physical function and overall health. It's a safe, beneficial method for enhancing well-being and fitness.
6,111 services225 patients
Therapy procedure using manual technique, each 15 minutes 97140
This therapy involves using hands-on techniques to help improve your body's movement and function. These techniques may include stretching, resistance exercises, or gentle pressure. Each session lasts 15 minutes and aims to relieve pain, promote healing, and improve your overall health.
2,363 services201 patients
Application of ultrasound, each 15 minutes 97035
Ultrasound is a medical procedure that uses high-frequency sound waves to capture live images from inside your body. It's a painless process typically lasting 15 minutes per session. This method aids in diagnosing conditions and monitoring health without any radiation exposure.
884 services151 patients
Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes 97112
This therapy helps retrain your brain, nerves, and muscles to work together. Through targeted exercises, your body learns to regain lost functions or improve current abilities. Each session lasts 15 minutes.
361 services58 patients
Evaluation for physical therapy, typically 20 minutes 97161
An evaluation for physical therapy is a short, 20-minute assessment where your physical condition, mobility, and pain levels are examined. This helps in designing a personalized therapy plan to enhance your physical function and well-being.
196 services175 patients
Therapy procedure using functional activities 97530
A therapy procedure using functional activities encourages you to use your own body movements in day-to-day tasks to aid recovery. It aims to improve your mobility, strength, and overall health by incorporating therapeutic exercises into your routine.
70 services60 patients

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

0/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality0
Improvement Activities0

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CALIFORNIA EMERGENCY PHYSICIANS
Physical Therapist
2048 LINCOLN AVE
SAN JOSE, CA 95125
Santa Clara County (408) 448-1677

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Andrew Petulla's NPI number?

The NPI number for Andrew Petulla is 1063426807. It was assigned to this individual provider in the NPPES registry on July 28, 2006.

Where is Andrew Petulla located?

Andrew Petulla practices at 2048 Lincoln Ave, San Jose, CA 95125. The listed phone number is (408) 448-1677.

What is Andrew Petulla's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Andrew Petulla enrolled in Medicare?

Yes. Andrew Petulla is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Andrew Petulla was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.