STEPHANIE BOULTER (PA-C) – Physician Assistant, NPI 1295970515
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,971 PHYSICIAN ASSISTANT in UT
Provider Addresses for STEPHANIE BOULTER (PA-C)
8132 S 3500 E
COTTONWOOD HEIGHTS, UT 841215956
Phone: (801) 995-1235
Fax: (800) 775-1064
Type: Mailing
1265 E FORT UNION BLVD STE 120
COTTONWOOD HEIGHTS, UT 840471845
Phone: (801) 917-5561
Fax: (800) 775-1064
Type: Location
Cypress Point Way, Draper Oaks, Draper, Salt Lake County, Utah, 84020-5626, United States
DRAPER, UT 840208808
Phone: (801) 995-1235
Fax: (801) 572-9992
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 13 Open Payments records for all available years, with a total value of $332.
Total Amount is formed as General ($332) + Research ($0) + Ownership ($0) = $332.
Last reported payment date: 2024-11-12 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($210).
Total Amount
$332
General + Research + Ownership
Payments
13
Total payment records
General Amount
$332
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Janssen Pharmaceuticals, Inc | $210 |
| Janssen Scientific Affairs, LLC | $45 |
| Neurocrine BioSciences Inc. | $31 |
| Alkermes, Inc. | $28 |
| ABBVIE INC. | $19 |
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: 2009-10-20
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 |
|---|---|---|---|---|
| I20091020000500 | I | Physician Assistant | UT | 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 84121)
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