Individual provider Active NPI

Vladislav Shut, D.P.T.

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1578501052
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1335 N la Brea Ave
Los Angeles, CA 90028-7526
Phone
(310) 246-1050
NPI assigned
Jun 4, 2006
Last updated
Nov 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X PT32430 CA
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

1335 N la Brea Ave
Los Angeles, CA 90028-7526

Mailing address

1335 N la Brea Ave Ste 3
Los Angeles, CA 90028-7565
Phone (310) 246-1050

Other identifiers 2

IdentifierTypeStateIssuer
205559183OtherCATAX ID
PT32430OtherCALICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060605000266 CA Practitioner - Physical Therapist in Private Practice 2860394236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
May accept Medicare assignment
Group practices
Back2 Health Physical Therapy IncGroup PAC ID 8527068246, 6 clinicians

Practice addresses (Care Compare)

930 W Alameda Ave
Burbank, CA 91506-2802
Phone (818) 588-3880

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Back2 Health Physical Therapy Inc Physical Medicine & Rehabilitation CurrentSince Sep 1, 2006 Accepting new patients
Strength Training Inc Past Accepting new patients
Strength Training Inc Physical Therapist PastSince Oct 1, 2001 Accepting new patients
Corpus Art Physical Therapy Professional Corp Physical Therapist PastSince Apr 30, 2003 Accepting new patients

Locations

930 W Alameda Ave
Burbank, CA 91506
Phone (818) 588-3880

1335 N La Brea Ave
Ste 3
Los Angeles, CA 90028
Phone (213) 297-4395

9201 W Sunset Blvd
Ste M120
West Hollywood, CA 90069
Phone (310) 246-1050

Organizations & group practices 4

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": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1578501052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1335 N LA BREA AVE STE 3",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900287565",
            "telephone_number": "310-246-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 N LA BREA AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900287526",
            "telephone_number": "310-246-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUT",
        "first_name": "VLADISLAV",
        "credential": "D.P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "PT32430",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "205559183",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PT32430",
            "state": "CA"
        }
    ],
    "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 Nov 21, 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.