Individual provider Active NPI

Joanna Stuppler, NP

  • Nurse Practitioner
  • Tarzana, CA
National Provider Identifier
1629666268
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95014465 Issued in CA
Practice address
18133 Ventura Blvd Ste C
Tarzana, CA 91356-3612
Phone
(818) 515-0091
NPI assigned
Jan 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95014465 CA Primary

Addresses

Primary practice location

18133 Ventura Blvd Ste C
Tarzana, CA 91356-3612

Mailing address

18133 Ventura Blvd Ste C
Tarzana, CA 91356-3612
Phone (818) 515-0091

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL JOANNA@REGENICS.COM Direct REGENICS

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
I20210609002761 CA Practitioner - Nurse Practitioner 9335549542 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Genesis Hospitalist Medical Group, Inc.Group PAC ID 2769846328, 11 clinicians

Practice addresses (Care Compare)

8700 Beverly Blvd
West Hollywood, CA 90048-1804
Phone (310) 786-7204

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95014465CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Hospitalist Medical Group, Inc. CurrentSince Mar 1, 2024 Accepting new patients
Apex Multispecialty Medical Group, Inc CurrentSince Apr 1, 2021 Accepting new patients
Playa Health LLC PastSince Jan 10, 2021 Accepting new patients
Playa Health P C PastSince Jan 10, 2021 Accepting new patients

Locations

9663 Santa Monica Blvd
Beverly Hills, CA 90210
Phone (310) 275-8377

600 S San Vicente Blvd
Los Angeles, CA 90048
Phone (310) 873-3312

8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1610064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1629666268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18133 VENTURA BLVD STE C",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563612",
            "telephone_number": "818-515-0091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18133 VENTURA BLVD STE C",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563612",
            "telephone_number": "818-515-0091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUPPLER",
        "first_name": "JOANNA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-08",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95014465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "JOANNA@REGENICS.COM",
            "affiliation": "Y",
            "affiliationName": "REGENICS",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "18133 Ventura Blvd Ste C",
            "city": "Tarzana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913563612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

Verify at the official NPI Registry.