Edward Shut

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

17227 Ventura Blvd
Encino, CA 91316-4007

Phone

(818) 990-9930

NPI assigned

Mar 23, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Group practices

Back2 Health Physical Therapy IncGroup PAC ID 8527068246, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Back2 Health Physical Therapy Inc

  • Physical Medicine & Rehabilitation Physician
  • Los Angeles, CA
  • NPI 1053419408

  Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1647993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1982353207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1335 N LA BREA AVE STE 3",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900287565",
            "telephone_number": "310-246-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17227 VENTURA BLVD",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913164007",
            "telephone_number": "818-990-9930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUT",
        "first_name": "EDWARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-23",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Rees Shulman, M.D.
• Tiffany Wing Sze Shum, MS, BCBA
• Susan Cook Shumway, M.D.
• Shushanik Gaboian Licensed Clinical Social Worker Inc.
• Summer Shuskey
• Anne Shutelock, MS RD LD
• Rachel Lea Sibner
• Hannah Calanit Sidener
• Yaffa Sidikaro
• Mark David Siegel, D.D.S.

• Physical Therapist in Encino, CA
• Providers in Encino, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; 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.