NPIMap

Organization Active NPI

Kulagy Physical Therapy, PC

Doing business as dba PeteHealth

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1265895080
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
KULAGY PHYSICAL THERAPY, PC
Doing business as
dba PeteHealth
Practice address
6080 Center Dr.
6TH Floor Suite # 639
Los Angeles, CA 90045-9205
Phone
(888) 859-0145
Fax
(888) 858-1601
NPI assigned
Mar 30, 2016
Last updated
Jan 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Authorized official

Name
Mr. Theodore StebenNPI 1053492546
Title
Coo
Phone
(424) 209-9433

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

6080 Center Dr.
6TH Floor Suite # 639
Los Angeles, CA 90045-9205

Mailing address

PO Box 1295
Venice, CA 90294-1295
Phone (888) 859-0145

Other names 1

  • dba PeteHealth Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161208001999 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9638459621 Receives reassigned benefits from 21 practitioners
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

12655 W Jefferson Blvd
Los Angeles, CA 90066
Phone (424) 285-0443

6080 Center Dr
Ste 639
Los Angeles, CA 90045

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1459296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706140800000",
    "number": "1265895080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1295",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902941295",
            "telephone_number": "888-859-0145",
            "fax_number": "888-858-1601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6080 CENTER DR.",
            "address_2": "6TH FLOOR SUITE # 639",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900459205",
            "telephone_number": "888-859-0145",
            "fax_number": "888-858-1601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KULAGY PHYSICAL THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-30",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A",
        "authorized_official_last_name": "STEBEN",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "424-209-9433",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba PeteHealth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.