MRS. LISA MICHELLE CASSIDY STULTZ (MS CCCSLP) – Speech-Language Pathologist, NPI 1568651107
Speech-Language Pathologist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
205 QUALIFIED SPEECH LANGUAGE PATHOLOGIST in IN
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Provider Addresses for MRS. LISA MICHELLE CASSIDY STULTZ (MS CCCSLP)
5214, South East Street, Indianapolis, Marion, Indiana, 46227, United States
BUILDING D SUITE 1
INDIANAPOLIS, IN 46227
Phone: (800) 486-4449
Fax: (317) 780-3750
Type: Mailing
18 ESTATE DR
MOORESVILLE, IN 461581216
Phone: (317) 374-6947
Type: Mailing
2141 N DAN JONES RD
AVON, IN 461236023
Phone: (317) 943-1837
Fax: (317) 780-3750
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: 2022-12-09
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20221209002612 | I | Qualified Speech Language Pathologist | IN | TBD |
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.
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 46227)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | IL | |
| Occupational Therapist In Private Practice | IL | |
| - | IL | |
| Occupational Therapist In Private Practice | IL | |
| - | MO | |
| Qualified Speech Language Pathologist | IL | |
| Qualified Speech Language Pathologist | IN | |
| Physical Therapist In Private Practice | MI | |
| Physical Therapist In Private Practice | MI | |
| Qualified Speech Language Pathologist | IN |
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