Individual provider Active NPI

Steven M Charbonnet, PHYSICAL THERAPY

  • Orthopedic Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1780105429
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
293115 Issued in CA
Practice address
6080 Center Dr FL 6
Los Angeles, CA 90045-9205
Phone
(888) 859-0145
NPI assigned
Jul 3, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 293115 CA Primary

Addresses

Primary practice location

6080 Center Dr FL 6
Los Angeles, CA 90045-9205

Mailing address

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

Other practice location 1

1600 Main St Fl 2
Venice, CA 90291-3626
Phone (888) 859-0145

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171027001069 CA Practitioner - Physical Therapist in Private Practice 1759657216 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kulagy Physical Therapy PCGroup PAC ID 9638459621, 17 clinicians

Practice addresses (Care Compare)

6060 Ctr Dr
FL 10
Los Angeles, CA 90045-1598
Phone (888) 859-0145

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
293115CAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hands on Rehab, Inc. CurrentSince Aug 24, 2020 Accepting new patients

Locations

7921 Professional Cir
Huntington Beach, CA 92648
Phone (714) 847-8751

Organizations & group practices 2

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": "1499040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1780105429",
    "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 FL 6",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900459205",
            "telephone_number": "888-859-0145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Main St Fl 2",
            "address_purpose": "LOCATION",
            "city": "Venice",
            "state": "CA",
            "postal_code": "902913626",
            "country_code": "US",
            "telephone_number": "888-859-0145",
            "fax_number": "888-858-1601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHARBONNET",
        "first_name": "STEVEN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PHYSICAL THERAPY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-03",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "293115",
            "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 Mar 27, 2023; 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.