Individual provider Active NPI

Amanda Stuart, DPT

  • Physical Therapist
  • Venice, CA
National Provider Identifier
1689129884
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT298868 Issued in CA
Practice address
122 Lincoln Blvd Ste 205
Venice, CA 90291-2859
Phone
(781) 879-8564
Fax
(310) 742-8474
NPI assigned
Aug 18, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT298868 CA Primary

Addresses

Primary practice location

122 Lincoln Blvd Ste 205
Venice, CA 90291-2859

Mailing address

122 Lincoln Blvd Ste 205
Venice, CA 90291-2859
Phone (781) 879-8564

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201006002170 CA Practitioner - Physical Therapist in Private Practice 7618396987 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

11500 W Olympic Blvd
Suite 470
Los Angeles, CA 90064-1530
Phone (424) 293-2305

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT298868CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Momentum Physical Therapy Physical Therapist CurrentSince Dec 1, 2024 Accepting new patients
Prendergast and Rummer Phys Therapy Pelvic Health & Rehabiliation Ctr Physical Therapist CurrentSince Dec 1, 2024 Accepting new patients
Touch of Life Physical Therapy, Inc. CurrentSince Sep 28, 2020 Accepting new patients
DTS, Inc. Therapy, Rehab & Exercise Physical Therapist PastSince Oct 26, 2020 Accepting new patients
Akincilar and Prendergast, Inc Physical Therapist PastSince Sep 26, 2023 Accepting new patients

Locations

11500 W Olympic Blvd
Ste 470
Los Angeles, CA 90064
Phone (310) 473-8287

7301 Medical Center Dr
Ste 104
West Hills, CA 91307
Phone (818) 887-7667

23101 Sherman Pl
Ste 150
West Hills, CA 91307
Phone (818) 887-7667

32 Daniel Webster Hwy
Ste 16
Merrimack, NH 03054
Phone (603) 589-9184

Organizations & group practices 5

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": "1471478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1689129884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 LINCOLN BLVD STE 205",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902912859",
            "telephone_number": "781-879-8564",
            "fax_number": "310-742-8474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 LINCOLN BLVD STE 205",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902912859",
            "telephone_number": "781-879-8564",
            "fax_number": "310-742-8474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUART",
        "first_name": "AMANDA",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-18",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT298868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.