Individual provider Active NPI

Kristina L. Stilwell, PA-C

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1114972726
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA16096 Issued in CA
Practice address
1225 Wilshire Boulevard
Los Angeles, CA 90017-2395
Phone
(213) 977-2423
Fax
(213) 202-7028
NPI assigned
May 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA16096 CA Primary

Addresses

Primary practice location

1225 Wilshire Boulevard
Los Angeles, CA 90017-2395

Mailing address

2550 North Hollywood Way
Suite 209
Burbank, CA 91505-5019
Phone (818) 557-0135

Other identifiers 1

IdentifierTypeStateIssuer
PA16096MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040227001052 CA Practitioner - Physician Assistant 4587551213 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
16096CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California CurrentSince Sep 2, 2012 Accepting new patients
Cep America - California CurrentSince Mar 11, 2010 Accepting new patients
Cep America - Auc PC CurrentSince Feb 1, 2016 Accepting new patients
Cep America - Auc, PC CurrentSince Feb 1, 2016 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jul 16, 2011 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jul 16, 2011 Accepting new patients

Locations

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

24451 Health Center Dr
Laguna Hills, CA 92653
Phone (949) 452-3573

22855 Lake Forest Dr
Ste A
Lake Forest, CA 92630
Phone (949) 452-7544

26137 La Paz Rd
Ste 120
Mission Viejo, CA 92691
Phone (949) 452-3309

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

Organizations & group practices 10

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1114972726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 NORTH HOLLYWOOD WAY",
            "address_2": "SUITE 209",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915055019",
            "telephone_number": "818-557-0135",
            "fax_number": "818-557-1394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 WILSHIRE BOULEVARD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900172395",
            "telephone_number": "213-977-2423",
            "fax_number": "213-202-7028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILWELL",
        "first_name": "KRISTINA",
        "middle_name": "L.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA16096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA16096",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.