CAMERON STUKEL (DPT) – Physical Therapist, NPI 1104700319

CAMERON STUKEL (DPT) is a healthcare provider. based in Tetonia, Idaho. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. 7671668 (ID). The NPI Number for CAMERON STUKEL (DPT) is 1104700319

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
CAMERON STUKEL (DPT)
NPI
1104700319
Phone
Not provided
Address
PO BOX 342
Enumeration Date
1 August 2025
Last Update Date
1 August 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3077349129
Graduation Year
2025 (1 year ago)
PAC ID
6305339375
Group Practice PAC ID
0345242178
Professional Enrollment ID
I20251208001442
Address ID
WY830018657JA120XXAVEX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

834 PHYSICAL THERAPIST IN PRIVATE PRACTICE in ID

Provider Addresses for CAMERON STUKEL (DPT)

  • PO BOX 342

    TETONIA, ID 834520342

    Phone:

    Type: Mailing

  • 39 W LITTLE AVE

    DRIGGS, ID 834225021

    Phone: (208) 354-9675

    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: 2025-12-08

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
I20251208001442IPhysical Therapist In Private PracticeWYTBD

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 83452)

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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: 0345242178View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeWY
-WY
-WY
Physical Therapist In Private PracticeCO
Physical Therapist In Private PracticeWY
Physical Therapist In Private PracticeUT
Physical Therapist In Private PracticePA
Physical Therapist In Private PracticePA

Reviews

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Frequently asked questions

What unique ID ties claims to CAMERON STUKEL (DPT)?
NPI 1104700319 is assigned to CAMERON STUKEL (DPT) under the national enumeration system.
Is CAMERON STUKEL (DPT)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does CAMERON STUKEL (DPT) list a primary specialty?
If you are matching referrals, note Physical Therapist for CAMERON STUKEL (DPT). Clinical services aligned with this taxonomy classification.
Where does public data place CAMERON STUKEL (DPT)?
The snapshot lists Tetonia, Idaho for CAMERON STUKEL (DPT); download NPPES for the complete set.
How can I contact CAMERON STUKEL (DPT)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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