Individual provider Active NPI

Lizbeth Acosta, PA-C, ATC

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1164923892
Registry record updated Dec 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
65976 Issued in CA
Practice address
3255 Wilshire Blvd Ste 120
Los Angeles, CA 90010-1404
Phone
(213) 235-2500
NPI assigned
Feb 27, 2018
Last updated
Dec 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 65976 CA Primary
Athletic Trainer 2255A2300X NU

Addresses

Primary practice location

3255 Wilshire Blvd Ste 120
Los Angeles, CA 90010-1404

Mailing address

3727 W 6TH St Ste 210
Los Angeles, CA 90020-5108
Phone (213) 235-2500

Other practice location 1

3727 W 6th St Ste 210
Los Angeles, CA 90020-5108
Phone (661) 476-7782

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
I20250506001460 CA Practitioner - Physician Assistant 2264959097 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
65976CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Korean Health, Education, Information and Research Center CurrentSince Dec 7, 2025 Accepting new patients
Korean Health Education Information and Research Center CurrentSince Apr 7, 2025 Accepting new patients

Locations

3255 Wilshire Blvd
Ste 120
Los Angeles, CA 90010
Phone (213) 235-1212

3727 W 6th St
Ste 200
Los Angeles, CA 90020
Phone (213) 235-2500

3727 W 6th St
Ste 210
Los Angeles, CA 90020
Phone (213) 235-2500

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1519689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764892800000",
    "number": "1164923892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3727 W 6TH ST STE 210",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900205108",
            "telephone_number": "213-235-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3255 WILSHIRE BLVD STE 120",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900101404",
            "telephone_number": "213-235-2500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3727 W 6th St Ste 210",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900205108",
            "country_code": "US",
            "telephone_number": "661-476-7782",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ACOSTA",
        "first_name": "LIZBETH",
        "credential": "PA-C, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-27",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "65976",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.