Stacey Kim Sbutega, P.T., D.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

41563 Issued in CA

Practice address

6801 Park Ter Ste 200
Los Angeles, CA 90045-1546

Phone

(310) 665-7100

Fax

(310) 665-7101

NPI assigned

Sep 18, 2014

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

• Stacey Kim Former name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Agile Physical Therapy IncGroup PAC ID 2163311556, 48 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.

• Agile Physical Therapy Inc

  • Physical Therapy Clinic/Center
  • Palo Alto, CA
  • NPI 1659445443
  Medicare reassignment Care Compare group NPD
• Cedars-Sinai Medical Care Foundation

  • Specialist
  • Los Angeles, CA
  • NPI 1316984388
  Medicare reassignment NPD
• Select CS Physical Therapy, P.C.

  • Physical Therapy Clinic/Center
  • Ridgecrest, CA
  • NPI 1386228302

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1410998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1073915286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4902 SEAPINE CIR",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926494412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 PARK TER STE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900451546",
            "telephone_number": "310-665-7100",
            "fax_number": "310-665-7101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6801 Park Ter Ste 250",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900451543",
            "country_code": "US",
            "telephone_number": "310-665-7200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SBUTEGA",
        "first_name": "STACEY",
        "middle_name": "KIM",
        "credential": "P.T., D.P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-18",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "41563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "KIM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Negin Sazgar, PHARM.D.
• Brenda D Sazo
• SB Palliative Care LLC
• Katherine Sborov, MD
• Casey Steven Sbrana
• SC Regional Medical Group, Inc.
• Anthony Albert Scaduto, M.D.
• Samuel C Scaffido
• Tania Lucia Scala
• Andrew Thomas Scales, DO

• Physical Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.