Liza Kustantin

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT16697 Issued in CA

Practice address

1515 N Alexandria Ave
Los Angeles, CA 90027-5203

Phone

(323) 660-1800

NPI assigned

Nov 21, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Powerback Rehabilitation LLC

  • Physical Therapist
  • Shelby Township, MI
  • NPI 1912226366

  Occupational Therapist

  Medicare reassignment NPD
• Powerback Rehabilitation LLC

  • Physical Therapist
  • Woodbridge, VA
  • NPI 1790640761

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1479686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1184167397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 PALM AVE",
            "address_2": "402",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900694066",
            "telephone_number": "586-596-0452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 N ALEXANDRIA AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900275203",
            "telephone_number": "323-660-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSTANTIN",
        "first_name": "LIZA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-21",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT16697",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201009655",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela R Kushner, M.D.
• Hannah Kushnick
• Alisa Kusolvisitkul, PHARMD
• Melanie Kusonruksa, M.D.
• Steven Russell Kussman, M.D.
• Yulia Kustova, P.A.
• Jehuda David Kusuma
• Sydney Kusumoputro, MD
• Ruvy Rose Dayrit Kutilek, NP
• Sean K Kutlay, D.D.S.

• Occupational Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; 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.