LUIS SEDANO IBARRA – Physical Therapist, NPI 1124908611

LUIS SEDANO IBARRA is a healthcare provider. based in San jose, California. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold a License No. 303020 (CA). The NPI Number for LUIS SEDANO IBARRA is 1124908611

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
LUIS SEDANO IBARRA
NPI
1124908611
Phone
(831) 999-0880
Address
1314 LINCOLN AVE STE 1F
Enumeration Date
4 September 2025
Last Update Date
4 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8319990880
Graduation Year
2022 (4 years ago)
PAC ID
8527557487
Group Practice PAC ID
9032659636
Professional Enrollment ID
I20251030002187
Address ID
CA95125XXXXSAXXXXXXXXXX00
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

9,522 PHYSICAL THERAPIST IN PRIVATE PRACTICE in CA

Provider Addresses for LUIS SEDANO IBARRA

  • 1314 LINCOLN AVE STE 1F

    SAN JOSE, CA 951253012

    Phone: (831) 999-0880

    Fax: (833) 435-3990

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-10-30

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251030002187IPhysical Therapist In Private PracticeCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 95125)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9032659636View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA
Occupational Therapist In Private PracticeNJ
Occupational Therapist In Private PracticeCA

Reviews

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Frequently asked questions

What identifier follows LUIS SEDANO IBARRA across health systems?
The NPI 1124908611 uniquely identifies LUIS SEDANO IBARRA in U.S. healthcare data.
Quick check: is LUIS SEDANO IBARRA active?
Public NPPES data shows LUIS SEDANO IBARRA with an active NPI status right now.
How should patients interpret LUIS SEDANO IBARRA's specialty?
The extract shows Physical Therapist for LUIS SEDANO IBARRA. Clinical services aligned with this taxonomy classification.
What city is tied to LUIS SEDANO IBARRA?
The directory associates LUIS SEDANO IBARRA with San Jose, California. Check all listed addresses for suites or satellite offices.
Why is information missing for LUIS SEDANO IBARRA?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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