STACI LILIEDAHL-MATIYOW (DPT) – Physical Therapist, NPI 1831592708

STACI LILIEDAHL-MATIYOW (DPT) is a healthcare provider. based in Council bluffs, Iowa. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. 03634 (IA). The NPI Number for STACI LILIEDAHL-MATIYOW (DPT) is 1831592708

Main info

Female
21 Years Of Experience
Accepts Medicare Assignment
Name
STACI LILIEDAHL-MATIYOW (DPT)
NPI
1831592708
Phone
(712) 329-9419
Address
201 W BROADWAY
Enumeration Date
6 October 2014
Last Update Date
6 October 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7123299419
Graduation Year
2005 (21 years ago)
PAC ID
8729304621
Group Practice PAC ID
2163317553
Professional Enrollment ID
I20150312001764
Address ID
IA515039004CO201XXBROA300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:11State licenses:2Digital endpointsOther names

1,303 PHYSICAL THERAPIST IN PRIVATE PRACTICE in IA

Provider Addresses for STACI LILIEDAHL-MATIYOW (DPT)

  • 201 W BROADWAY

    COUNCIL BLUFFS, IA 515039004

    Phone: (712) 329-9419

    Fax: (712) 329-0329

    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: 2015-03-12

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
I20150312001764IPhysical Therapist In Private PracticeIATBD

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
97140Therapy procedure using manual technique, each 15 minutes1,861158$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes960158$0
G0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care723140$0
97113Therapy procedure using water pool to exercises, each 15 minutes37017$0
97161Evaluation for physical therapy, typically 20 minutes5249$0
View full utilization report →

Insurance plans in this area (ZIP 51503)

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Provider's Procedures

STACI LILIEDAHL-MATIYOW (DPT) performs procedures in PHYSICAL THERAPIST IN PRIVATE PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYIA97140Manual (physical) therapy techniques to 1 or more regions, each 15 minutes875182

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: 2163317553View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeIA
Physical Therapist In Private PracticeIA

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Frequently asked questions

Does STACI LILIEDAHL-MATIYOW (DPT) have a public NPI I can cite?
Public records show STACI LILIEDAHL-MATIYOW (DPT) under NPI 1831592708.
Is STACI LILIEDAHL-MATIYOW (DPT)'s NPI status active today?
Active status means STACI LILIEDAHL-MATIYOW (DPT)'s NPI record is not deactivated in the public file.
What services align with STACI LILIEDAHL-MATIYOW (DPT)'s listing?
STACI LILIEDAHL-MATIYOW (DPT)'s public classification highlights Physical Therapist. Clinical services aligned with this taxonomy classification.
What geographic area is tied to STACI LILIEDAHL-MATIYOW (DPT)?
STACI LILIEDAHL-MATIYOW (DPT) is associated with Council Bluffs, Iowa 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.