MRS. KIMBERLY MARIE STUMPHAUZER PT
NPI 1790748044
Physical Therapist in Elyria, OH

NPI Status: Active since April 08, 2006

Contact Information

137 WINCKLES ST
ELYRIA, OH
ZIP 44035
Phone: (440) 366-5993
Fax: (440) 366-5313

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  • Individual
  • Female
  • Years of Experience 34
  • Physical Therapist
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • Medicare Quality Reporting

About KIMBERLY STUMPHAUZER

This page provides the complete NPI Profile along with additional information for Kimberly Stumphauzer, a provider established in Elyria, Ohio with a medical specialization in Physical Therapist and more than 34 years of experience. The healthcare provider is registered in the NPI registry with number 1790748044 assigned on April 2006. The practitioner's primary taxonomy code is 225100000X with license number PT06051 (OH). The provider is registered as an individual and her NPI record was last updated April 2025.

NPI
1790748044
Provider Name
MRS. KIMBERLY MARIE STUMPHAUZER PT
Gender
Female
Entity Type
Individual
Location Address
137 WINCKLES ST ELYRIA, OH 44035
Location Phone
(440) 366-5993
Location Fax
(440) 366-5313
Mailing Address
137 WINCKLES ST ELYRIA, OH 44035
Mailing Phone
(440) 366-5993
Mailing Fax
(440) 366-5313
Medical School Name
OTHER
Graduation Year
1992
Is Sole Proprietor?
Yes
Enumeration Date
04-08-2006
Last Update Date
04-29-2025
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physical Therapist

Taxonomy Code
225100000X
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
License No.
PT06051
License State
OH
Taxonomy Description
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Anthem Bronze Pathway HMO 7450 for HSA - HMO
  • Anthem Bronze Pathway HMO 7500 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Bronze Pathway HMO 9200 ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Bronze Pathway HMO 9200 Adult Dental & Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Catastrophic Pathway HMO 9200 - HMO
  • Anthem Gold Pathway HMO 1500 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Heart Healthy Bronze Pathway HMO 6000 ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Heart Healthy Silver Pathway X HMO 6000 ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Silver Pathway HMO 4000 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Silver Pathway HMO 5000 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Bronze $8,300 w/ Virtual & Wellness ON-EX - HMO
  • Bronze HSA $7,300 ON-EX - HMO
  • Bronze Standard w/ Virtual & Wellness - HMO
  • Gold $1250 w/ Virtual & Wellness ON-EX - HMO
  • Gold $500 w/ Virtual & Wellness ON-EX - HMO
  • Gold Standard w/ Virtual & Wellness - HMO
  • Silver $5000 w/ Virtual & Wellness ON-EX - HMO
  • Silver Standard w/ Virtual & Wellness - HMO
  • SilverSelect w/ Virtual & Wellness ON-EX - HMO
  • Young Adult Essentials ON-EX - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
654140OTHER (01)OHAETNA
341490517042OTHER (01)OHCARESOURCE
2167462MEDICAID (05)OH 
000000192879OTHER (01)OHANTHEM BLUE CROSS BLUE SH

Medicare Participation & PECOS Enrollment Status

Kimberly Stumphauzer is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • PECOS PAC ID: 2567586613

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20140602001016

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Application of ultrasound, each 15 minutes

Ultrasound is a medical procedure that uses high-frequency sound waves to capture live images from inside your body. It's a painless process typically lasting 15 minutes per session. This method aids in diagnosing conditions and monitoring health without any radiation exposure.

This service was performed 242 times for 49 patients

Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care

Electrical stimulation is a therapy method where mild electrical pulses are used to treat pain or stimulate muscles in certain areas. It's not for wound care but is part of a broader therapy plan. It's safe, non-invasive, and can help improve overall health.

This service was performed 117 times for 31 patients

Evaluation for physical therapy, typically 20 minutes

An evaluation for physical therapy is a short, 20-minute assessment where your physical condition, mobility, and pain levels are examined. This helps in designing a personalized therapy plan to enhance your physical function and well-being.

This service was performed 68 times for 62 patients

Evaluation for physical therapy, typically 30 minutes

An evaluation for physical therapy is a 30-minute session where a physical therapist assesses your current physical condition. They'll examine your strength, flexibility, balance, and mobility to identify areas needing improvement. This helps tailor a therapy plan to your specific needs.

This service was performed 32 times for 29 patients

Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes

This therapy helps retrain your brain, nerves, and muscles to work together. Through targeted exercises, your body learns to regain lost functions or improve current abilities. Each session lasts 15 minutes.

This service was performed 824 times for 81 patients

Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes

This therapy involves exercises to boost strength, endurance, flexibility, and range of motion. Each session lasts 15 minutes. The goal is to improve physical function and overall health. It's a safe, beneficial method for enhancing well-being and fitness.

This service was performed 935 times for 110 patients

Therapy procedure using functional activities

A therapy procedure using functional activities encourages you to use your own body movements in day-to-day tasks to aid recovery. It aims to improve your mobility, strength, and overall health by incorporating therapeutic exercises into your routine.

This service was performed 247 times for 44 patients

Therapy procedure using manual technique, each 15 minutes

This therapy involves using hands-on techniques to help improve your body's movement and function. These techniques may include stretching, resistance exercises, or gentle pressure. Each session lasts 15 minutes and aims to relieve pain, promote healing, and improve your overall health.

This service was performed 79 times for 22 patients

Therapy procedure using water pool to exercises, each 15 minutes

This therapy involves exercising in a water pool for 15-minute intervals. The buoyancy of the water supports your body, reducing stress on joints and muscles. It's beneficial for improving strength, flexibility, and balance. It's a gentle, low-impact form of exercise suitable for all ages.

This service was performed 436 times for 16 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $21.18 for a new patient copayment and $17.01 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 44035 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $84.72
  • Minimum New Patient Price $54.34
  • Maximum New Patient Price $166.65
  • Average New Patient Copayment $21.18
  • Minimum New Patient Copayment $13.58
  • Maximum New Patient Copayment $41.66

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $68.07
  • Minimum Established Patient Price $17.1
  • Maximum Established Patient Price $135.4
  • Average Established Patient Copayment $17.01
  • Minimum Established Patient Copayment $4.27
  • Maximum Established Patient Copayment $33.85

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 100% 26
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1790748044
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
271801441608
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 8 + 0 + 1 + 4 + 4 + 1 + 6 + 0 + 8 + 24 = 66
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 66 = 44

The NPI number 1790748044 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 7 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1811014046 HOLLY L TAYLOR SLP
Individual
Speech-Language Pathologist137 WINCKLES ST
ELYRIA, OH 44035
(440) 366-5993
1205958667MRS. LAURA MARIE BREESE ATC
Individual
Specialist/Technologist (Athletic Trainer)137 WINCKLES ST
ELYRIA, OH 44035
(440) 366-5993
1477754588JAWORSKI PHYSICAL THERAPY INC
Organization
Durable Medical Equipment & Medical Supplies137 WINCKLES ST
ELYRIA, OH 44035
(440) 366-5993
1669074977DR. ANN PLAS PT, DPT
Individual
Physical Therapist137 WINCKLES ST
ELYRIA, OH 44035
(440) 366-5993
1891248563 JOSHUA WOLF PT
Individual
Physical Therapist137 WINCKLES ST
ELYRIA, OH 44035
(440) 366-5993
1558015446 ZACHARY S NEWTON DPT
Individual
Physical Therapist137 WINCKLES ST
ELYRIA, OH 44035
(440) 366-5993
1902340243 ANN HAMKER AT
Individual
Specialist/Technologist (Athletic Trainer)137 WINCKLES ST
ELYRIA, OH 44035
(440) 366-5993

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1790748044, enumerated in the NPI registry as an "individual" on April 08, 2006

The provider is located at 137 Winckles St Elyria, Oh 44035 and the phone number is (440) 366-5993

The provider's speciality is Physical Therapist with taxonomy code 225100000X

The provider has more than 34 years of experience.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, MedMutual,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Medicare beneficiaries should expect a typical cost of $84.72 with an average copayment of $21.18 for new patient appointments. Established patients should expect a typical charge of $68.07 and an average copayment of 17.01. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Application of ultrasound, each 15 minutes, Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care, Evaluation for physical therapy, typically 20 minutes, Evaluation for physical therapy, typically 30 minutes, Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes, Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes, Therapy procedure using functional activities, Therapy procedure using manual technique, each 15 minutes and Therapy procedure using water pool to exercises, each 15 minutes.

This NPI record was last updated on April 08, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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