Individual provider Active NPI

Stacey Shuai

  • Pediatrics Physician
  • Culver City, CA
National Provider Identifier
1124472592
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A-152482 Issued in CA
Practice address
5901 Green Valley Cir Ste 405
Culver City, CA 90230-6971
Phone
(424) 266-7474
NPI assigned
Apr 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A-152482 CA Primary

Addresses

Primary practice location

5901 Green Valley Cir Ste 405
Culver City, CA 90230-6971

Mailing address

5901 Green Valley Cir Ste 405
Culver City, CA 90230-6971
Phone (424) 266-7474

Other practice location 1

200 Corporate Pointe Ste 50
Culver City, CA 90230-8726
Phone (424) 266-7474

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200925001602 CA Practitioner - Pediatric Medicine 6103245097 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A-152482CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Achievable Foundation CurrentSince Aug 1, 2020 Accepting new patients
The Achievable Foundation PastSince Mar 11, 2025 Accepting new patients

Locations

5901 Green Valley Cir
Ste 405
Culver City, CA 90230
Phone (424) 266-7472

100 Corporate Pointe
Ste 270
Los Angeles, CA 90230

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73523

Organizations & group practices 2

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": "1461196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780876800000",
    "number": "1124472592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 GREEN VALLEY CIR STE 405",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902306971",
            "telephone_number": "424-266-7474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 GREEN VALLEY CIR STE 405",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902306971",
            "telephone_number": "424-266-7474"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Corporate Pointe Ste 50",
            "address_purpose": "LOCATION",
            "city": "Culver City",
            "state": "CA",
            "postal_code": "902308726",
            "country_code": "US",
            "telephone_number": "424-266-7474",
            "fax_number": "310-596-8268",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHUAI",
        "first_name": "STACEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-21",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A-152482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

Verify at the official NPI Registry.