CARLY RUSSO WHITTAKER (DPT) – Physical Therapist, NPI 1316402894

CARLY RUSSO WHITTAKER (DPT) is a healthcare provider. based in Dallas, Texas. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. 1315328 (TX). The NPI Number for CARLY RUSSO WHITTAKER (DPT) is 1316402894

Main info

Female
Sole Proprietor
8 Years Of Experience
Accepts Medicare Assignment
Name
CARLY RUSSO WHITTAKER (DPT)
NPI
1316402894
Phone
(610) 737-8046
Address
2425 VICTORY AVE APT 264
Enumeration Date
8 February 2019
Last Update Date
3 February 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9728457875
Graduation Year
2018 (8 years ago)
PAC ID
4385033141
Group Practice PAC ID
7618208752
Professional Enrollment ID
I20211116002545
Address ID
TX750811864RI1761XPKWY301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness85
Years active:7State licenses:1Digital endpointsOther names

5,353 PHYSICAL THERAPIST IN PRIVATE PRACTICE in TX

Provider Addresses for CARLY RUSSO WHITTAKER (DPT)

  • 2425 VICTORY AVE APT 264

    DALLAS, TX 752197720

    Phone: (610) 737-8046

    Mailing address matches the actual address.

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: 2021-11-16

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
I20211116002545IPhysical Therapist In Private PracticeTXTBD

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
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes42823$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes17321$0
97140Therapy procedure using manual technique, each 15 minutes10420$0
97530Therapy procedure using functional activities8624$0
97162Evaluation for physical therapy, typically 30 minutes1212$0
View full utilization report →

Insurance plans in this area (ZIP 75219)

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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: 7618208752View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeTX
Clinical PsychologistTX
Clinical PsychologistTX
Physical Therapist In Private PracticeTX
Clinical PsychologistTX
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeTX
-TX
Clinical PsychologistTX
Physical Therapist In Private PracticeTX

Reviews

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Frequently asked questions

What NPI should I save for CARLY RUSSO WHITTAKER (DPT)?
Save NPI 1316402894 if you need a stable reference for CARLY RUSSO WHITTAKER (DPT).
Is CARLY RUSSO WHITTAKER (DPT)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does CARLY RUSSO WHITTAKER (DPT) list a primary specialty?
If you are matching referrals, note Physical Therapist for CARLY RUSSO WHITTAKER (DPT). Clinical services aligned with this taxonomy classification.
Where does public data place CARLY RUSSO WHITTAKER (DPT)?
The snapshot lists Dallas, Texas for CARLY RUSSO WHITTAKER (DPT); download NPPES for the complete set.
What if Dallas, Texas seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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