DR. ROY A ETTA PT,DPT
NPI 1972464055
Physical Therapist in Brambleton, VA

Active since November 19, 2025Accepts Medicare Assignment
42365 SOAVE DR STE 200, BRAMBLETON, VA 20148(571) 349-3116(571) 349-3119 Get Directions Write a Review

NPPES record last updated: August 27, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 27, 2026, Nov 26, 2025, Nov 19, 2025 (3 updates tracked since 2025).

About Dr. Roy A Etta Pt,dpt NPPES

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

DR. ROY A ETTA PT,DPT (NPI 1972464055) is an individual physical therapist in Brambleton, Virginia, licensed in Virginia (CP051278T) and active in the NPI registry since November 2025. He maintains 4 additional practice locations and is a graduate of Other (2025).

NPPES Registry Identity

NPI1972464055
Entity TypeIndividualMale
Primary Taxonomy225100000X
Provider Legal NameDR. ROY A ETTACredential: PT,DPT
Location Address42365 SOAVE DR STE 200Brambleton, VA 20148-4888
Mailing Address12701 Fair Lakes Cir Ste 102Fairfax, VA 22033-4913 · (571) 349-3116 · Fax (571) 349-3119
Fax(571) 349-3119
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateNovember 19, 2025
Last NPPES UpdateAugust 27, 20263 updates tracked since enumeration
NPPES CertifiedAugust 27, 2026
✔ NPI 1972464055 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
Licenses✔ Licensed in VA · CP051278T✔ Licensed in GA · CP060348T✔ Licensed in TN · 16530
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
42365 SOAVE DR STE 200, Brambleton, VA 20148

Secondary Practice Locations 4

Location 12801 N Decatur Rd Ste 230Decatur, GA 30033-7430 · Phone (404) 294-7211
Location 21301 Sigman Rd NE Ste 220Conyers, GA 30012-3819 · Phone (678) 210-0311
Location 34743 Atlanta Hwy Ste 100Loganville, GA 30052-2686 · Phone (770) 466-9343
Location 42400 Wisteria Dr Ste ASnellville, GA 30078-2689 · Phone (770) 982-0102

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Roy A Etta Pt,dpt is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9739673112
PECOS Enrollment IDI20251212001381, I20251216004084

Medicare Billing Reassignment

Medicare enrollment records show Roy Etta reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Physical Therapist
5900 FORT DR STE 208
Centreville, VA 20121
  • Reassigned Medicare billing, District of Columbia and Virginia enrollments
  • 206 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20148 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$86.88 typical visit price
range $56.19 – $170.30
Typical copayment $21.72 (range $14.04 – $42.57)
Most-billed visit code 99203
Established Patient
$70.08 typical visit price
range $18.07 – $138.91
Typical copayment $17.52 (range $4.51 – $34.72)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 11

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

Physical Therapist
42365 SOAVE DR STE 200
BRAMBLETON, VA 20148
Physical Therapist
42365 SOAVE DR STE 200
BRAMBLETON, VA 20148
Physical Therapist
42365 SOAVE DR STE 200
BRAMBLETON, VA 20148
Physical Therapist
42365 SOAVE DR STE 200
BRAMBLETON, VA 20148
Physical Therapist
42365 SOAVE DR STE 200
BRAMBLETON, VA 20148
Physical Therapist
42365 SOAVE DR STE 200
BRAMBLETON, VA 20148
Physical Therapist
42365 SOAVE DR STE 200
BRAMBLETON, VA 20148
Physical Therapist
42365 SOAVE DR STE 200
BRAMBLETON, VA 20148

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 Roy Etta's NPI number?

The NPI number for Roy Etta is 1972464055. It was assigned to this individual provider in the NPPES registry on November 19, 2025.

Where is Roy Etta located?

Roy Etta practices at 42365 Soave Dr Ste 200, Brambleton, VA 20148. The listed phone number is (571) 349-3116.

What is Roy Etta's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Roy Etta enrolled in Medicare?

Yes. Roy Etta is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Roy Etta's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Roy Etta reassigns Medicare benefits to Jackson Clinics Limited Partnership (Centreville, VA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Roy Etta's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Roy Etta was last updated on August 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.