Nicole Mariko Elby Lee, PT,DPT,SCS,ATC,CSCS

Primary specialty

Sports Physical TherapistTaxonomy code 2251S0007X

License

PT292166 Issued in CA

Practice address

24255 Pacific Coast Hwy
Malibu, CA 90263-3999

Phone

(310) 506-4000

NPI assigned

Aug 3, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Nicole Mariko Elby Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Compete Physical Therapy

  • Home Health Agency
  • Playa del Rey, CA
  • NPI 1891306809
  NPD Authorized official
• Elite Orthosport Physical Therapy

  • Physical Therapy Clinic/Center
  • Los Angeles, CA
  • NPI 1215280706
  NPD (past)

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

{
    "created_epoch": "1501718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1861917577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24255 PACIFIC COAST HWY",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902633999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24255 PACIFIC COAST HWY",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902633999",
            "telephone_number": "310-506-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "NICOLE",
        "middle_name": "MARIKO ELBY",
        "credential": "PT,DPT,SCS,ATC,CSCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-03",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "CA",
            "license": "PT292166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "ELBY",
            "middle_name": "MARIKO",
            "credential": "PT,DPT,SCS,ATC,CSCS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elizabeth Krumrei
• Rachael Kuhn
• Lananh DO, M.D. Inc
• Corey B. Larsen, M.D.
• Lucy Kaiser Larson, M.D.
• Leisure Living, Inc.
• Justin J. Leitstein, LMFT
• Justin Letzt, DC
• Life Line Wound Care Inc.
• Lifeline Wound Care

• Sports Physical Therapist in Malibu, CA
• Providers in Malibu, CA by specialty
• Sports Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.