Active NPI
Rebecca Michelle Stull, PNP-PC, RN
- Pediatric Nurse Practitioner
- Los Angeles, CA
National Provider Identifier
1689401432
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 95030984
- Practice address
- 4650 W Sunset Blvd
Los Angeles, CA 90027-6062 - Phone
- (323) 660-2450
- NPI assigned
- Sep 16, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 95030984 | CA | Primary |
Addresses
Primary practice location
4650 W Sunset Blvd
Los Angeles, CA 90027-6062
Mailing address
1235 W Town and Country Rd Apt 3423
Orange, CA 92868-4677
Phone (909) 631-5496
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
3250 Wilshire Blvd
Suite 1101
Los Angeles, CA 90010-1513
3701 Wilshire Blvd
Suite 600
Los Angeles, CA 90010-2814
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95030984 | CA | MD | Pediatric Nurse Practitioner |
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- Los Angeles, CA
- NPI 1265530653
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1726444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726444800000",
"number": "1689401432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1235 W TOWN AND COUNTRY RD APT 3423",
"city": "ORANGE",
"state": "CA",
"postal_code": "928684677",
"telephone_number": "909-631-5496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4650 W SUNSET BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900276062",
"telephone_number": "323-660-2450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STULL",
"first_name": "REBECCA",
"middle_name": "MICHELLE",
"name_prefix": "Miss",
"credential": "PNP-PC, RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-16",
"last_updated": "2024-09-16",
"certification_date": "2024-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "CA",
"license": "95030984",
"primary": true
}
],
"identifiers": [],
"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 Sep 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.