Individual provider Active NPI

Kyra Denise Pineda Sabando, PT

  • Physical Therapist
  • Corona, CA
National Provider Identifier
1114515137
Registry record updated May 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
4300 Green River Rd Ste 114
Corona, CA 92878-2306
Phone
(951) 382-4238
NPI assigned
Jan 5, 2021
Reactivated
Nov 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

4300 Green River Rd Ste 114
Corona, CA 92878-2306

Mailing address

6656 Whitewell Rd
Eastvale, CA 92880-9154

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220712003582 CA Practitioner - Physical Therapist in Private Practice 6901287697 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hanson and Associates Physical TherapyGroup PAC ID 2365712015, 2 clinicians

Practice addresses (Care Compare)

4300 Green River Rd
Suite 114
Corona, CA 92878-2306
Phone (951) 382-4238

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kevin O. Lawrence MD Inc PastSince Mar 29, 2022 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1609804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653091200000",
    "number": "1114515137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6656 WHITEWELL RD",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "928809154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 GREEN RIVER RD STE 114",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928782306",
            "telephone_number": "951-382-4238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SABANDO",
        "first_name": "KYRA DENISE",
        "middle_name": "PINEDA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-05",
        "last_updated": "2022-05-21",
        "certification_date": "2021-11-22",
        "deactivation_date": "2021-01-29",
        "reactivation_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.