Individual provider Active NPI

Jacob Yochanan Stibelman

  • Foot Surgery Podiatrist
  • Beverly Hills, CA
National Provider Identifier
1134879885
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
E6121 Issued in CA
Practice address
200 N Robertson Blvd Ste 202
Beverly Hills, CA 90211-6002
Phone
(310) 385-6017
NPI assigned
Mar 25, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Foot Surgery Podiatrist 213ES0131X E6121 CA Primary

Addresses

Primary practice location

200 N Robertson Blvd Ste 202
Beverly Hills, CA 90211-6002

Mailing address

4140 W 190TH St
Torrance, CA 90504-5513

Other practice location 1

8700 Beverly Blvd
Suite 8215NT
Los Angeles, CA 90048-1804
Phone (818) 314-4586

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250804001320 CA Practitioner - Podiatry 7719495522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Western Un of HLTH Sciences, Col of Podiatric Med, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians

Practice addresses (Care Compare)

200 N Robertson Blvd
Suite 202
Beverly Hills, CA 90211-6002
Phone (310) 423-3078

Hospital & facility affiliations

  • Cedars-Sinai Medical Center Hospital, Los Angeles, CA, CCN 050625

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue15
Removal of nail tissue49
Removal or shaving of skin growth26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E6121CAMDFoot Surgery Podiatrist
6121CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Care Foundation CurrentSince Jul 30, 2025 Accepting new patients

Locations

200 N Robertson Blvd
Ste 202
Beverly Hills, CA 90211
Phone (310) 385-3300

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

8700 Beverly Blvd
Ste 8215NT
West Hollywood, CA 90048
Phone (310) 423-4508

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1648166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1134879885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 W 190TH ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905045513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N ROBERTSON BLVD STE 202",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902116002",
            "telephone_number": "310-385-6017"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8700 Beverly Blvd",
            "address_2": "Suite 8215NT",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900481804",
            "country_code": "US",
            "telephone_number": "818-314-4586",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STIBELMAN",
        "first_name": "JACOB",
        "middle_name": "YOCHANAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-25",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "CA",
            "license": "E6121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.