STEPHANIE M SULLIVAN (DPT) – Physical Therapist, NPI 1861650970

STEPHANIE M SULLIVAN (DPT) is a healthcare provider. based in Indianapolis, Indiana. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. 11-03805 (KS). The NPI Number for STEPHANIE M SULLIVAN (DPT) is 1861650970

Main info

Female
Sole Proprietor
23 Years Of Experience
Accepts Medicare Assignment
Name
STEPHANIE M SULLIVAN (DPT)
NPI
1861650970
Phone
(866) 360-9355
Address
911 E 86TH ST STE 103
Enumeration Date
26 May 2008
Last Update Date
21 October 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9377498447
Graduation Year
2003 (23 years ago)
PAC ID
3971038332
Group Practice PAC ID
5193036432
Professional Enrollment ID
I20241121001965
Address ID
OH453732337TR81XXXRDXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience69
Completeness75
Years active:18State licenses:2Digital endpointsOther names

2,243 PHYSICAL THERAPIST IN PRIVATE PRACTICE in OH

Provider Addresses for STEPHANIE M SULLIVAN (DPT)

  • 911 E 86TH ST STE 103

    INDIANAPOLIS, IN 462401840

    Phone: (866) 360-9355

    Type: Mailing

  • 800 GRAYSON LN

    BEAVERCREEK, OH 454301783

    Phone: (866) 360-9355

    Type: Location

  • 806, Linda Drive, Atlantic, Cass County, Iowa, 50022, United States

    ATLANTIC, IA 500222727

    Phone: (402) 981-1555

    Type: Mailing

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: 2024-11-21

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
I20241121001965IPhysical Therapist In Private PracticeOHTBD

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 46240)

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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: 5193036432View full group profile
NameSpecialtyState
-MO
-AL
-IL
Qualified Speech Language PathologistFL
-MO
Occupational Therapist In Private PracticeUT
Physical Therapist In Private PracticeWI
-WI
-WI
-FL

Reviews

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Frequently asked questions

Does STEPHANIE M SULLIVAN (DPT) have a public NPI I can cite?
Public records show STEPHANIE M SULLIVAN (DPT) under NPI 1861650970.
Is STEPHANIE M SULLIVAN (DPT)'s NPI status active today?
Active status means STEPHANIE M SULLIVAN (DPT)'s NPI record is not deactivated in the public file.
What services align with STEPHANIE M SULLIVAN (DPT)'s listing?
STEPHANIE M SULLIVAN (DPT)'s public classification highlights Physical Therapist. Clinical services aligned with this taxonomy classification.
What geographic area is tied to STEPHANIE M SULLIVAN (DPT)?
STEPHANIE M SULLIVAN (DPT) is associated with Indianapolis, Indiana in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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