CARLY FULLER (PT DPT) – Physical Therapist, NPI 1063297778

CARLY FULLER (PT DPT) is a healthcare provider. based in Reston, Virginia. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT DPT. They hold a License No. 2305215948 (VA). The NPI Number for CARLY FULLER (PT DPT) is 1063297778

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
CARLY FULLER (PT DPT)
NPI
1063297778
Phone
(703) 230-1760
Address
1760 RESTON PKWY STE 403
Enumeration Date
30 August 2023
Last Update Date
30 August 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7032301760
Graduation Year
2023 (3 years ago)
PAC ID
9537514146
Group Practice PAC ID
9830296367
Professional Enrollment ID
I20231016003724
Address ID
VA201903360RE1760XPKWY301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

3,079 PHYSICAL THERAPIST IN PRIVATE PRACTICE in VA

Provider Addresses for CARLY FULLER (PT DPT)

  • 1760 RESTON PKWY STE 403

    RESTON, VA 201903360

    Phone: (703) 230-1760

    Fax: (702) 230-1761

    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: 2023-10-16

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
I20231016003724IPhysical Therapist In Private PracticeDCTBD

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 activities17913$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes17213$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes14513$0
97161Evaluation for physical therapy, typically 20 minutes1111$0
View full utilization report →

Insurance plans in this area (ZIP 20190)

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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: 9830296367View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeVA
Physical Therapist In Private PracticeVA
Physical Therapist In Private PracticeVA
Physical Therapist In Private PracticeVA
-VA
-MD
Physical Therapist In Private PracticeVA
Physical Therapist In Private PracticeVA
Physical Therapist In Private PracticeVA
Physical Therapist In Private PracticeVA

Reviews

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Frequently asked questions

What is the registry number for CARLY FULLER (PT DPT)?
The registry entry for CARLY FULLER (PT DPT) shows NPI 1063297778.
Is CARLY FULLER (PT DPT) currently accepting referrals based on NPI status?
Registry metadata lists CARLY FULLER (PT DPT) as active.
How should patients interpret CARLY FULLER (PT DPT)'s specialty?
The extract shows Physical Therapist for CARLY FULLER (PT DPT). Clinical services aligned with this taxonomy classification.
What city is tied to CARLY FULLER (PT DPT)?
The directory associates CARLY FULLER (PT DPT) with Reston, Virginia. Check all listed addresses for suites or satellite offices.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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