MRS. STEPHANIE THADAL – Psychiatric/Mental Health Nurse Practitioner, NPI 1235989393

MRS. STEPHANIE THADAL is a healthcare provider. based in Port saint lucie, Florida. specializing in NURSE PRACTITIONER. They hold a License No. 406512 (NY). The NPI Number for MRS. STEPHANIE THADAL is 1235989393

Main info

Female
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
MRS. STEPHANIE THADAL
NPI
1235989393
Phone
(954) 417-5985
Address
1555 NW SAINT LUCIE WEST BLVD
Enumeration Date
22 March 2024
Last Update Date
4 May 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8132774571
Graduation Year
2023 (3 years ago)
PAC ID
6709316961
Group Practice PAC ID
9739420654
Professional Enrollment ID
I20250710001799
Address ID
FL328396019OR4700XBLVD301
Data current as of
3 June 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness85
Years active:2State licenses:2Digital endpointsOther names

24,232 NURSE PRACTITIONER in FL

Provider Addresses for MRS. STEPHANIE THADAL

  • 1555 NW SAINT LUCIE WEST BLVD

    PORT SAINT LUCIE, FL 349861758

    Phone: (954) 417-5985

    Fax: (754) 339-0006

    Type: Mailing

  • 13101 40th Rd Apt 15C

    Flushing, NY 113545245

    Phone: (954) 417-5985

    Fax: (754) 339-0006

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $42.

Total Amount is formed as General ($42) + Research ($0) + Ownership ($0) = $42.

Last reported payment date: 2024-06-13 • Largest payer in this snapshot: Alkermes, Inc. ($23).

Total Amount

$42

General + Research + Ownership

Payments

2

Total payment records

General Amount

$42

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-06-13

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2025-07-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20250204001660INurse PractitionerNYTBD
I20250710001799INurse PractitionerFLTBD

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 34986)

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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: 9739420654View full group profile
NameSpecialtyState
Nurse PractitionerFL
Nurse PractitionerFL
Clinical PsychologistFL
Clinical PsychologistLA
Nurse PractitionerFL
Nurse PractitionerFL
Clinical PsychologistNJ
Clinical PsychologistPR
Clinical PsychologistPR
Nurse PractitionerCT

Reviews

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Frequently asked questions

How do payers reference MRS. STEPHANIE THADAL?
For MRS. STEPHANIE THADAL, use NPI 1235989393 as the unique 10-digit identifier.
Is MRS. STEPHANIE THADAL still an active registrant?
MRS. STEPHANIE THADAL carries an active NPI according to the public dataset.
What expertise is attributed to MRS. STEPHANIE THADAL?
MRS. STEPHANIE THADAL's specialty line reads Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where in Florida is MRS. STEPHANIE THADAL registered?
Use Port Saint Lucie, Florida as the headline location for MRS. STEPHANIE THADAL here.
When was this NPI issued?
Enumeration for MRS. STEPHANIE THADAL is noted as March 22, 2024 where the registry provides it.

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