DR. STEFANIE DEPAUL (PT, DPT, CSCS, RYT) – Physical Therapist, NPI 1104181650

DR. STEFANIE DEPAUL (PT, DPT, CSCS, RYT) is a healthcare provider. based in Boston, Massachusetts. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT, CSCS, RYT. They hold a License No. 20089 (MA). The NPI Number for DR. STEFANIE DEPAUL (PT, DPT, CSCS, RYT) is 1104181650

Main info

Female
Sole Proprietor
14 Years Of Experience
Accepts Medicare Assignment
Name
DR. STEFANIE DEPAUL (PT, DPT, CSCS, RYT)
NPI
1104181650
Phone
(617) 375-8644
Address
4 AVERY ST
Enumeration Date
11 July 2012
Last Update Date
30 July 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6178435320
Graduation Year
2012 (14 years ago)
PAC ID
3577711696
Group Practice PAC ID
2961823760
Professional Enrollment ID
I20120914000572
Address ID
MA021803600ST62XXXAVEX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:13State licenses:1Digital endpointsOther names

2,873 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MA

Provider Addresses for DR. STEFANIE DEPAUL (PT, DPT, CSCS, RYT)

  • 4 AVERY ST

    BOSTON, MA 021111005

    Phone: (617) 375-8644

    Fax: (617) 375-8581

    Type: Location

  • 62 MONTVALE AVE STE Z

    STONEHAM, MA 021803600

    Phone: (617) 843-5320

    Fax: (774) 272-8474

    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: 2012-09-14

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
I20120914000572IPhysical Therapist In Private PracticeMATBD

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
97530Therapy procedure using functional activities52447$0
97140Therapy procedure using manual technique, each 15 minutes49348$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes44747$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes44045$0
97535Training for self-care or home management, each 15 minutes5836$0
View full utilization report →

Insurance plans in this area (ZIP 02111)

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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: 2961823760View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeMA
Physical Therapist In Private PracticeNY
Physical Therapist In Private PracticeMA
Physical Therapist In Private PracticeMA
Physical Therapist In Private PracticeMA
Physical Therapist In Private PracticeMA

Reviews

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Frequently asked questions

How do payers reference DR. STEFANIE DEPAUL (PT, DPT, CSCS, RYT)?
For DR. STEFANIE DEPAUL (PT, DPT, CSCS, RYT), use NPI 1104181650 as the unique 10-digit identifier.
Would DR. STEFANIE DEPAUL (PT, DPT, CSCS, RYT) appear as active to a payer?
You can treat DR. STEFANIE DEPAUL (PT, DPT, CSCS, RYT) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with DR. STEFANIE DEPAUL (PT, DPT, CSCS, RYT)?
DR. STEFANIE DEPAUL (PT, DPT, CSCS, RYT)'s record emphasizes Physical Therapist. Clinical services aligned with this taxonomy classification.
What locale is associated with DR. STEFANIE DEPAUL (PT, DPT, CSCS, RYT)?
Directory geography for DR. STEFANIE DEPAUL (PT, DPT, CSCS, RYT) centers on Boston, Massachusetts.
What does 4 location(s) imply?
4 practice locations appear in the available data.

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