MALLORY MATTEO – Physical Therapist, NPI 1205213451

MALLORY MATTEO is a healthcare provider. based in Bristol, Connecticut. specializing in Physical Therapist. They hold a License No. 009674 (CT). The NPI Number for MALLORY MATTEO is 1205213451

Main info

Female
13 Years Of Experience
Accepts Medicare Assignment
Name
MALLORY MATTEO
NPI
1205213451
Phone
(860) 589-1881
Address
255 N Main St
Enumeration Date
27 April 2015
Last Update Date
19 July 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5095451010
Graduation Year
2013 (13 years ago)
PAC ID
0749578128
Group Practice PAC ID
9234029000
Professional Enrollment ID
I20190925001367
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:11State licenses:2Digital endpointsOther names

Provider Addresses for MALLORY MATTEO

  • 255 N Main St

    Bristol, CT 060104972

    Phone: (860) 589-1881

    Type: Location

  • 6825 BURDEN BLVD STE D

    PASCO, WA 993015633

    Phone: (509) 416-0444

    Fax: (509) 545-1112

    Type: Mailing

  • 1908 GEORGE WASHINGTON WAY STE B

    RICHLAND, WA 993542386

    Phone: (509) 375-1015

    Fax: (509) 375-1381

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-02-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220216001610IPhysical Therapist In Private PracticeCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06010)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9234029000View full group profile

Reviews

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Frequently asked questions

What is the 10-digit NPI for MALLORY MATTEO?
MALLORY MATTEO — NPI 1205213451 — is the standard way to identify this listing.
Can I rely on MALLORY MATTEO being an active provider?
As of the registry snapshot, MALLORY MATTEO is marked active.
What taxonomy line describes MALLORY MATTEO?
For research purposes, treat MALLORY MATTEO as Physical Therapist in this dataset. Clinical services aligned with this taxonomy classification.
Does MALLORY MATTEO list a practice location?
Patients near Bristol, Connecticut may find MALLORY MATTEO in results; validate coverage separately.
How many locations tie to this NPI?
3 practice locations appear in the available data.

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