Stefanie Depaul, PT, DPT, CSCS, RYT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

20089 Issued in MA

Practice address

62 Montvale Ave Ste Z
Stoneham, MA 02180-3600

Phone

(617) 843-5320

Fax

(774) 272-8474

NPI assigned

Jul 11, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Dr. Stefanie Rousselle Former name

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Boston Health and Wellness LLCGroup PAC ID 2961823760, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Boston Health & Wellness, LLC

  • Physical Therapist
  • Stoneham, MA
  • NPI 1033738489

  MA, Single Specialty

  Medicare reassignment Care Compare group NPD Authorized official
• Athletic Evolution Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Woburn, MA
  • NPI 1346744216

  MA, Physical Therapist

  Medicare reassignment NPD
• Athletic Evolution Strength and Conditioning, Inc

  • Physical Medicine & Rehabilitation Physician
  • Woburn, MA
  • NPI 1538987953

  Physical Therapist

  NPD (past)
• Spine & Sports Injury Center, P.C.

  • Physical Therapy Clinic/Center
  • Boston, MA
  • NPI 1649479395

  Physical Therapist

  NPD (past)
• Spine & Sports Injury Center, P.C.

  • Chiropractor
  • Boston, MA
  • NPI 1891840922

  Single Specialty

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1104181650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 MONTVALE AVE STE Z",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021803600",
            "telephone_number": "617-843-5320",
            "fax_number": "774-272-8474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 MONTVALE AVE STE Z",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021803600",
            "telephone_number": "617-843-5320",
            "fax_number": "774-272-8474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPAUL",
        "first_name": "STEFANIE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, CSCS, RYT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-11",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "20089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEFANIE",
            "last_name": "ROUSSELLE",
            "prefix": "DR.",
            "credential": "PT, DPT, CSCS, RYT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daniel W. Bienkowski, MD,PC
• Marc Deangelo, ATC, LAT
• Jill Elizabeth Decologero, ANP-BC, MSN
• Mary Ellen Delger, PA
• Danielle Demarco, PA-C
• Donald John Deraska, MD
• Kristina R. Derosier, PT
• Christina Desrochers
• Sanjiban Dey, MD
• Dha Endoscopy LLC

• Physical Therapist in Stoneham, MA
• Providers in Stoneham, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.