Individual provider Active NPI

Michelle Rae Imperio Sabangan, PT, DPT

  • Physical Therapist
  • San Bernardino, CA
National Provider Identifier
1902745276
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT309871 Issued in CA
Practice address
275 W Hospitality LN Ste 100
San Bernardino, CA 92408-3238
Phone
(909) 567-2221
Fax
(909) 763-3216
NPI assigned
Mar 25, 2026
Last updated
Mar 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

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 PT309871 CA Primary

Addresses

Primary practice location

275 W Hospitality LN Ste 100
San Bernardino, CA 92408-3238

Mailing address

2654 Richmond CT
San Bernardino, CA 92408-4113
Phone (909) 520-2676

Other practice location 1

25915 Barton Rd Ste 206
Loma Linda, CA 92354-3818
Phone (909) 686-6903

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260507004322 CA Practitioner - Physical Therapist in Private Practice 7416425434 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2654 Richmond CT
San Bernardino, CA 92408-4113

275 W Hospitality LN
Suite 100
San Bernardino, CA 92408-3238

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT309871CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Transit Physical Therapy PC Physical Therapist CurrentSince Nov 1, 2023 Accepting new patients

Locations

25915 Barton Rd
Ste 206
Loma Linda, CA 92354
Phone (909) 686-6903

275 W Hospitality Ln
Ste 100
San Bernardino, CA 92408
Phone (909) 567-2221

Organizations & group practices 1

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": "1774396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1902745276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2654 RICHMOND CT",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924084113",
            "telephone_number": "909-520-2676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 W HOSPITALITY LN STE 100",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083238",
            "telephone_number": "909-567-2221",
            "fax_number": "909-763-3216"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25915 Barton Rd Ste 206",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923543818",
            "country_code": "US",
            "telephone_number": "909-686-6903",
            "fax_number": "909-796-0550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SABANGAN",
        "first_name": "MICHELLE RAE",
        "middle_name": "IMPERIO",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-25",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT309871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2026; 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.