TYRA BONANNO
NPI 1306651716
Occupational Therapist in San Diego, CA

Active since February 12, 2025
7151 NAVAJO RD APT 5203, SAN DIEGO, CA 92119(619) 980-2930 Get Directions Write a Review

NPPES record last updated: May 27, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 27, 2025, Feb 12, 2025 (2 updates tracked since 2025).

About Tyra Bonanno NPPES

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

TYRA BONANNO (NPI 1306651716) is an individual occupational therapist in San Diego, California, licensed in California (25689) and active in the NPI registry since February 2025.

NPPES Registry Identity

NPI1306651716
Entity TypeIndividualFemale
Primary Taxonomy225X00000X
Provider Legal NameTYRA BONANNO
Location Address7151 NAVAJO RD APT 5203San Diego, CA 92119-4615
Mailing Address7151 Navajo Rd Apt 5203San Diego, CA 92119-4615
Sole ProprietorNo
Enumeration DateFebruary 12, 2025
Last NPPES UpdateMay 27, 20252 updates tracked since enumeration
NPPES CertifiedFebruary 12, 2025
✔ NPI 1306651716 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225X00000X
License✔ Licensed in CA · 25689
Definition
An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.
7151 NAVAJO RD APT 5203, San Diego, CA 92119

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tyra Bonanno is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

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

Health Maintenance Organization
4647 ZION AVE
San Diego, CA 92120
  • Reassigned Medicare billing, California enrollment
  • 13,921 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.

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 Tyra Bonanno's NPI number?

The NPI number for Tyra Bonanno is 1306651716. It was assigned to this individual provider in the NPPES registry on February 12, 2025.

Where is Tyra Bonanno located?

Tyra Bonanno practices at 7151 Navajo Rd Apt 5203, San Diego, CA 92119. The listed phone number is (619) 980-2930.

What is Tyra Bonanno's specialty?

The primary specialty registered for this NPI is Occupational Therapist with taxonomy code 225X00000X.

Is Tyra Bonanno enrolled in Medicare?

Yes. Tyra Bonanno is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Tyra Bonanno's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tyra Bonanno reassigns Medicare benefits to Southern California Permanente Medical Group (San Diego, 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 Tyra Bonanno'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 Tyra Bonanno was last updated on May 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.