MR. EDENBOROUGH GENOSA HIBIONADA
NPI 1912891615
Physical Therapist - Geriatrics in Myrtle Beach, SC

Q: What is Edenborough Hibionada's NPI number?

The NPI number for Edenborough Hibionada is 1912891615. It was assigned to this individual provider in the NPPES registry on June 6, 2025.

Q: What is Edenborough Hibionada's specialty?

The primary specialty registered for this NPI is Physical Therapist, specializing in Geriatrics, with taxonomy code 2251G0304X.

Active since June 06, 2025Accepts Medicare Assignment

3412 PICKET FENCE LN, MYRTLE BEACH, SC 29579(843) 450-4936 Get Directions Write a Review

NPPES record last updated: June 6, 2025. Verified against the NPPES registry weekly; last sync: November 08, 2026.

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About Mr. Edenborough Genosa Hibionada NPPES

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

MR. EDENBOROUGH GENOSA HIBIONADA (NPI 1912891615) is an individual geriatrics provider in Myrtle Beach, South Carolina, licensed in South Carolina (2841) and active in the NPI registry since June 2025. He is a graduate of Other (1994).

NPPES Registry Identity

NPI1912891615

Entity TypeIndividualMale

Primary Taxonomy2251G0304X

Provider Legal NameMR. EDENBOROUGH GENOSA HIBIONADA

Location Address3412 PICKET FENCE LNMyrtle Beach, SC 29579-3323

Mailing Address3412 Picket Fence LnMyrtle Beach, SC 29579-3323 · (843) 450-4936

Phone(843) 450-4936

Sole ProprietorYes

Medical School CMSOtherGraduated 1994

Enumeration DateJune 6, 2025

NPPES CertifiedJune 6, 2025

✔ NPI 1912891615 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Therapist · GeriatricsRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code2251G0304X

License✔ Licensed in SC · 2841

Definition

A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Geriatric Physical Therapy, who has demonstrated specialized knowledge and skill in the comprehensive biopsychosocial assessment and evidence-based management of movement in aging adults. This includes, but is not limited to, specialized knowledge in and consideration of normal age-related changes and pathological manifestations across all systems; cognition and mental health; polypharmacy; fall risk mitigation; bone health; healthy and active aging, and socioeconomic and health policy issues affecting aging adults. The geriatric physical therapist is an integral part of the interdisciplinary geriatric team and serves as an advocate for the highest level of well-being for the older adult.

3412 PICKET FENCE LN, Myrtle Beach, SC 29579

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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

Mr. Edenborough Genosa Hibionada 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 ID5597260141

PECOS Enrollment IDI20250924003547

Medicare Billing Reassignment

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

The Weston Group Of South Carolina Inc

155 mi

Physical Therapist

60 OAK FOREST RD
Bluffton, SC 29910

Reassigned Medicare billing, South Carolina enrollment
138 clinicians in this Medicare group

NPI 1073957064 (610) 438-2020

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 Edenborough Hibionada's NPI number?

The NPI number for Edenborough Hibionada is 1912891615. It was assigned to this individual provider in the NPPES registry on June 6, 2025.

Where is Edenborough Hibionada located?

Edenborough Hibionada practices at 3412 Picket Fence Ln, Myrtle Beach, SC 29579. The listed phone number is (843) 450-4936.

What is Edenborough Hibionada's specialty?

The primary specialty registered for this NPI is Physical Therapist, specializing in Geriatrics, with taxonomy code 2251G0304X.

Is Edenborough Hibionada enrolled in Medicare?

Yes. Edenborough Hibionada 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 Edenborough Hibionada's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Edenborough Hibionada reassigns Medicare benefits to The Weston Group Of South Carolina Inc (Bluffton, SC). 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 Edenborough Hibionada'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 Edenborough Hibionada was last updated on June 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.