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STEPHANIE BOULTER PA-C
NPI 1295970515
Physician Assistant in Cottonwood Heights, UT

Active since December 16, 2008PECOS Enrolled
1265 E FORT UNION BLVD STE 120, COTTONWOOD HEIGHTS, UT 84047(801) 917-5561(800) 775-1064 Get Directions Write a Review

NPPES record last updated: August 12, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 12, 2025, Mar 25, 2017 (2 updates tracked since 2017).

About Stephanie Boulter Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STEPHANIE BOULTER PA-C (NPI 1295970515) is an individual physician assistant in Cottonwood Heights, Utah and active in the NPI registry since December 2008. She is enrolled in Medicare PECOS and is a graduate of Other (2008).

NPPES Registry Identity

NPI1295970515
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameSTEPHANIE BOULTERCredential: PA-C
Location Address1265 E FORT UNION BLVD STE 120Cottonwood Heights, UT 84047-1845
Mailing Address8132 S 3500 ECottonwood Heights, UT 84121-5956 · (801) 995-1235 · Fax (800) 775-1064
Phone(801) 917-5561
Fax(800) 775-1064
Sole ProprietorNo
Medical School CMSOtherGraduated 2008
Enumeration DateDecember 16, 2008
Last NPPES UpdateAugust 12, 20252 updates tracked since enumeration
NPPES CertifiedAugust 12, 2025
✔ NPI 1295970515 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
1265 E FORT UNION BLVD STE 120, Cottonwood Heights, UT 84047
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Select Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Stephanie Boulter Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2567509730
PECOS Enrollment IDI20091020000500
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84047 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$68.01 typical visit price
range $17.23 – $135.20
Typical copayment $17.00 (range $4.30 – $33.80)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SURGICAL SYNERGY, LLC
Physician Assistant
1265 E FORT UNION BLVD STE 120
COTTONWOOD HEIGHTS, UT 84047
Salt Lake County (801) 917-5561

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stephanie Boulter's NPI number?

The NPI number for Stephanie Boulter is 1295970515. It was assigned to this individual provider in the NPPES registry on December 16, 2008.

Where is Stephanie Boulter located?

Stephanie Boulter practices at 1265 E Fort Union Blvd Ste 120, Cottonwood Heights, UT 84047. The listed phone number is (801) 917-5561.

What is Stephanie Boulter's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Stephanie Boulter enrolled in Medicare?

Yes. Stephanie Boulter is registered in the Medicare PECOS enrollment system.

What insurance does Stephanie Boulter accept?

Health plans from Select Health list Stephanie Boulter as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Stephanie Boulter was last updated on August 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.