KEONI REI STALLWORTH DPT
NPI 1154163186
Physical Therapist in Los Angeles, CA

Active since June 11, 2024Accepts Medicare Assignment
1640 MARENGO ST HBA 102, LOS ANGELES, CA 90089(323) 865-1200 Get Directions Write a Review

NPPES record last updated: March 3, 2025. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Mar 3, 2025, Jun 11, 2024 (2 updates tracked since 2024).

About Keoni Rei Stallworth Dpt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEONI REI STALLWORTH DPT (NPI 1154163186) is an individual physical therapist in Los Angeles, California, licensed in California (PT306848) and active in the NPI registry since June 2024. He is a graduate of University Of Southern California Keck School Of Medicine (2024).

NPPES Registry Identity

NPI1154163186
Entity TypeIndividualMale
Primary Taxonomy225100000X
Provider Legal NameKEONI REI STALLWORTHCredential: DPT
Location Address1640 MARENGO ST HBA 102Los Angeles, CA 90089-3603
Mailing AddressPo Box 31309Los Angeles, CA 90031-0309 · (626) 457-6601
Sole ProprietorYes
Medical School CMSUniversity Of Southern California Keck School Of MedicineGraduated 2024
Enumeration DateJune 11, 2024
Last NPPES UpdateMarch 3, 20252 updates tracked since enumeration
NPPES CertifiedMarch 3, 2025
✔ NPI 1154163186 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
License✔ Licensed in CA · PT306848
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
Also ListedPhysical Therapist · SportsTaxonomy 2251S0007X · License PENDING (CA)
1640 MARENGO ST HBA 102, Los Angeles, CA 90089

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Keoni Rei Stallworth Dpt is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8820522451
PECOS Enrollment IDI20241105002636

Medicare Billing Reassignment

Medicare enrollment records show Keoni Stallworth reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

General Practice
1520 SAN PABLO ST
Los Angeles, CA 90033
  • Reassigned Medicare billing, California enrollment
  • 2,445 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90089 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Keoni Stallworth's NPI number?

The NPI number for Keoni Stallworth is 1154163186. It was assigned to this individual provider in the NPPES registry on June 11, 2024.

Where is Keoni Stallworth located?

Keoni Stallworth practices at 1640 Marengo St Hba 102, Los Angeles, CA 90089. The listed phone number is (323) 865-1200.

What is Keoni Stallworth's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Keoni Stallworth enrolled in Medicare?

Yes. Keoni Stallworth is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Keoni Stallworth's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Keoni Stallworth reassigns Medicare benefits to Usc Care Medical Group, Inc (Los Angeles, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Keoni Stallworth's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Keoni Stallworth was last updated on March 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.