Individual provider Active NPI

Stefi Susan Simon

  • Occupational Therapist
  • Los Angeles, CA
National Provider Identifier
1174335129
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
27526 Issued in CA
Practice address
3392 Motor Ave
Los Angeles, CA 90034-3712
Phone
(310) 742-2230
NPI assigned
Jan 24, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 27526 CA Primary

Addresses

Primary practice location

3392 Motor Ave
Los Angeles, CA 90034-3712

Mailing address

19002 Tajauta Ave
Carson, CA 90746-2741
Phone (310) 414-7039

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251231002538 CA Practitioner - Occupational Therapist in Private Practice 2264928076 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Matrix Physical Therapy and Wellness PCGroup PAC ID 7416243662, 14 clinicians
Profizix Physical Therapy and Wellness PCGroup PAC ID 6103237599, 3 clinicians

Practice addresses (Care Compare)

2730 Wilshire Blvd
Suite 105
Santa Monica, CA 90403-4724
Phone (949) 307-6857

3392 Motor Ave
Los Angeles, CA 90034-3712
Phone (310) 742-2230

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Profizix Physical Therapy and Wellness P.C. CurrentSince Dec 1, 2025 Accepting new patients

Locations

3392 Motor Ave
Los Angeles, CA 90034
Phone (310) 202-1133

3402 Motor Ave
Ste C
Los Angeles, CA 90034
Phone (310) 873-3772

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": "1737676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1174335129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19002 TAJAUTA AVE",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907462741",
            "telephone_number": "310-414-7039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3392 MOTOR AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900343712",
            "telephone_number": "310-742-2230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "STEFI",
        "middle_name": "SUSAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-24",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "27526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; 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.