ANEESH AMBALAL M.D.
NPI 1114165057
Student in an Organized Health Care Education/Training Program in Santa Clara, CA
About Aneesh Ambalal M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANEESH AMBALAL M.D. (NPI 1114165057) is an individual student in an organized health care education/training program in Santa Clara, California and active in the NPI registry since January 2009. He is enrolled in Medicare PECOS and is a graduate of Other (2006).
NPPES Registry Identity
Specialties & Licenses
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
Aneesh Ambalal M.d. 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.
Medicare Billing Reassignment
Medicare enrollment records show Aneesh Ambalal reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Santa Clara, CA 95051
- Reassigned Medicare billing, California enrollment
- 20,078 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.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SANTA CLARA, CA 95051
SANTA CLARA, CA 95051
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 Aneesh Ambalal's NPI number?
The NPI number for Aneesh Ambalal is 1114165057. It was assigned to this individual provider in the NPPES registry on January 30, 2009.
Where is Aneesh Ambalal located?
Aneesh Ambalal practices at 710 Lawrence Expy Gme Dept 384, Santa Clara, CA 95051. The listed phone number is (408) 851-7203.
What is Aneesh Ambalal's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Aneesh Ambalal enrolled in Medicare?
Yes. Aneesh Ambalal 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 Aneesh Ambalal's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Aneesh Ambalal reassigns Medicare benefits to Permanente Medical Group Inc (Santa Clara, 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 Aneesh Ambalal'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 Aneesh Ambalal was last updated on February 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.
# Aneesh Ambalal, M.D. · NPI 1114165057
Student in an Organized Health Care Education/Training Program provider in Santa Clara, California. Individual provider, active in the CMS NPPES registry since January 30, 2009.
## Identity
- **NPI:** 1114165057 (Entity type: Individual)
- **Enumerated:** January 30, 2009
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 710 LAWRENCE EXPY, GME DEPT 384, Santa Clara, CA 95051-5173
- **Phone:** (408) 851-7203
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Permanente Medical Group Inc (NPI 1073606299, Santa Clara, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2006
## Record status
- **NPPES last updated:** February 11, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1114165057) · Data from the CMS NPPES public registry.