Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Edenborough Genosa Hibionada

Individual provider Geriatric Physical Therapist · NPI 1912891615

Mr. Edenborough Genosa Hibionada is a Physical Therapist in Private Practice in Myrtle Beach, South Carolina. Qualified in 1994, 32 years ago. Practices with The Weston Group of South Carolina Inc, a 80-clinician group and accepts Medicare assignment. Licensed in South Carolina.

Years since qualifying
32
Licensed in
SC
In the registry since
2025

Practice location Address checks out

3412 Picket Fence Ln
Myrtle Beach, SC 29579-3323
Phone: (843) 450-4936
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Geriatric Physical Therapist (primary) Taxonomy 2251G0304X · Licence 2841 (SC)

Record details

NPI number1912891615
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 6, 2025
Last updated in NPPESJune 6, 2025
Certification dateJune 6, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1994 (32 years in practice)
Group practice The Weston Group Of South Carolina Inc — 80 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount