MS. MARY MATTIS (P.T.) – Physical Therapist, NPI 1780817148

MS. MARY MATTIS (P.T.) is a healthcare provider. based in South daytona, Florida. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials P.T.. They hold a License No. PT14465 (FL). The NPI Number for MS. MARY MATTIS (P.T.) is 1780817148

Main info

Female
Sole Proprietor
33 Years Of Experience
Name
MS. MARY MATTIS (P.T.)
NPI
1780817148
Phone
(386) 763-0084
Address
401 Venture Dr
Enumeration Date
1 September 2009
Last Update Date
9 April 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8036499797
Graduation Year
1993 (33 years ago)
PAC ID
1658403670
Group Practice PAC ID
3678745320
Professional Enrollment ID
I20200429002247
Address ID
SC298037330AI943XXRDXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience65
Completeness75
Years active:16State licenses:2Digital endpointsOther names

4,636 PHYSICAL THERAPIST IN PRIVATE PRACTICE in FL

Provider Addresses for MS. MARY MATTIS (P.T.)

  • 401 Venture Dr

    Ste B

    South Daytona, FL 321193478

    Phone: (386) 763-0084

    Type: Location

  • 2330 S Nova Rd Bldg 2

    South Daytona, FL 321192514

    Phone: (386) 846-7062

    Type: Location

  • 943, Pine Log Road, Cardinal Park, Aiken, Aiken County, South Carolina, 29803, United States

    AIKEN, SC 298037330

    Phone: (803) 649-9797

    Type: Location

  • 465, Greenwich Drive, Hidden Haven, Aiken, Aiken County, South Carolina, 29803, United States

    AIKEN, SC 298036541

    Phone: (386) 846-7062

    Type: Mailing

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: 2020-04-29

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
I20200429002247IPhysical Therapist In Private PracticeSCTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97530Therapy procedure using functional activities778162$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes672155$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes353118$0
97140Therapy procedure using manual technique, each 15 minutes21977$0
97162Evaluation for physical therapy, typically 30 minutes7976$0
View full utilization report →

Insurance plans in this area (ZIP 32119)

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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: 3678745320View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeSC
Physical Therapist In Private PracticeSC
Physical Therapist In Private PracticeVT
-SC
-SC
Physical Therapist In Private PracticeMA
-SC
Physical Therapist In Private PracticeSC

Reviews

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Frequently asked questions

Does MS. MARY MATTIS (P.T.) have a public NPI I can cite?
Public records show MS. MARY MATTIS (P.T.) under NPI 1780817148.
Is MS. MARY MATTIS (P.T.) currently accepting referrals based on NPI status?
Registry metadata lists MS. MARY MATTIS (P.T.) as active.
Which specialty label fits MS. MARY MATTIS (P.T.)?
NPPES ties MS. MARY MATTIS (P.T.) to Physical Therapist in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is MS. MARY MATTIS (P.T.) tied to South Daytona, Florida?
If you are local to South Daytona, Florida, MS. MARY MATTIS (P.T.) may be relevant to your search.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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