Individual provider Active NPI

Karissa Ruth Deptula, PT, DPT

  • Physical Therapist
  • Colorado Springs, CO
National Provider Identifier
1962376707
Registry record updated Oct 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL.0020745 Issued in CO
Practice address
5643 N Academy Blvd
Colorado Springs, CO 80918-3658
Phone
(720) 316-9974
Fax
(720) 294-0332
NPI assigned
Oct 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTL.0020745 CO Primary

Addresses

Primary practice location

5643 N Academy Blvd
Colorado Springs, CO 80918-3658

Mailing address

PO Box 21150
Boulder, CO 80308-4150
Phone (720) 316-9974

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251211001587 CO Practitioner - Physical Therapist in Private Practice 1951895416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Physioroom, LLCGroup PAC ID 0941552863, 13 clinicians

Practice addresses (Care Compare)

11665 Ridgeline Dr
Suite 140
Colorado Springs, CO 80921-3959
Phone (720) 316-9974

8925 Ridgeline Blvd
Suite 102
Highlands Ranch, CO 80129-2354
Phone (720) 560-5326

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTL.0020745COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Physioroom, LLC Current Accepting new patients
The Physioroom, LLC CurrentSince Nov 3, 2025 Accepting new patients
The Physioroom, LLC Physical Therapist CurrentSince Nov 3, 2025 Accepting new patients

Locations

5643 N Academy Blvd
Colorado Springs, CO 80918
Phone (720) 316-9974

8925 Ridgeline Blvd
Ste 102
Highlands Ranch, CO 80129
Phone (720) 316-9974

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1759449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759449600000",
    "number": "1962376707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21150",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803084150",
            "telephone_number": "720-316-9974",
            "fax_number": "720-294-0332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5643 N ACADEMY BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809183658",
            "telephone_number": "720-316-9974",
            "fax_number": "720-294-0332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPTULA",
        "first_name": "KARISSA",
        "middle_name": "RUTH",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-03",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0020745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2025; 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.