KELLY SUE STOLEY-ROESNER (PT) – Physical Therapist, NPI 1063466969

KELLY SUE STOLEY-ROESNER (PT) is a healthcare provider. based in Rockford, Michigan. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. 5501004056 (MI). The NPI Number for KELLY SUE STOLEY-ROESNER (PT) is 1063466969

Main info

Female
37 Years Of Experience
Accepts Medicare Assignment
Name
KELLY SUE STOLEY-ROESNER (PT)
NPI
1063466969
Phone
(616) 866-6103
Address
8522 OAKBROOK RDG NE
Enumeration Date
22 May 2006
Last Update Date
22 October 2024

Doctor Profile

Medical School Name
UNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Secondary Phone
6164597101
Graduation Year
1989 (37 years ago)
PAC ID
0446784060
Group Practice PAC ID
9537136403
Professional Enrollment ID
I20241105002243
Address ID
MI495256406GR1111XNEXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

3,459 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MI

Provider Addresses for KELLY SUE STOLEY-ROESNER (PT)

  • 8522 OAKBROOK RDG NE

    ROCKFORD, MI 493419375

    Phone: (616) 866-6103

    Type: Mailing

  • 1111 LEFFINGWELL AVE NE

    GRAND RAPIDS, MI 495256406

    Phone: (616) 459-7101

    Type: Mailing

  • 570, East Division Street, Rockford, Kent County, Michigan, 49341, United States

    ROCKFORD, MI 493411323

    Phone: (616) 866-0141

    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: 2024-11-05

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
I20241105002243IPhysical Therapist In Private PracticeMITBD

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 49341)

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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: 9537136403View full group profile
NameSpecialtyState
Occupational Therapist In Private PracticeMI
Orthopedic SurgeryNH
Hand SurgeryMI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
-MI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Physical Medicine And RehabilitationMI
Physician AssistantMI

Reviews

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Frequently asked questions

What is the registry number for KELLY SUE STOLEY-ROESNER (PT)?
The registry entry for KELLY SUE STOLEY-ROESNER (PT) shows NPI 1063466969.
Is KELLY SUE STOLEY-ROESNER (PT) currently accepting referrals based on NPI status?
Registry metadata lists KELLY SUE STOLEY-ROESNER (PT) as active.
How should patients interpret KELLY SUE STOLEY-ROESNER (PT)'s specialty?
The extract shows Physical Therapist for KELLY SUE STOLEY-ROESNER (PT). Clinical services aligned with this taxonomy classification.
What geographic area is tied to KELLY SUE STOLEY-ROESNER (PT)?
KELLY SUE STOLEY-ROESNER (PT) is associated with Rockford, Michigan in the same public data insurers reference.
Who maintains KELLY SUE STOLEY-ROESNER (PT)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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