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NIMY BOBY KANDATHIL
NPI 1114792454
Social Worker - Clinical in San Jose, CA

Active since November 16, 2023PECOS Enrolled
7196 ALDER SPRING WAY, SAN JOSE, CA 95139(832) 475-7626 Get Directions Write a Review

NPPES record last updated: November 16, 2023. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Nimy Boby Kandathil NPPES

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

NIMY BOBY KANDATHIL (NPI 1114792454) is an individual clinical provider in San Jose, California, licensed in California (98757) and active in the NPI registry since November 2023. She is enrolled in Medicare PECOS and maintains a secondary practice location in San Jose.

NPPES Registry Identity

NPI1114792454
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameNIMY BOBY KANDATHIL
Location Address7196 ALDER SPRING WAYSan Jose, CA 95139-1301
Mailing Address7196 Alder Spring WaySan Jose, CA 95139-1301 · (832) 475-7626
Phone(832) 475-7626
Sole ProprietorYes
Enumeration DateNovember 16, 2023
NPPES CertifiedNovember 14, 2023
✔ NPI 1114792454 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in CA · 98757
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
7196 ALDER SPRING WAY, San Jose, CA 95139
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Secondary Practice Location 1

Location 12510, N. 1st Street STE 650San Jose, CA 95131 · Phone (832) 475-7626

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nimy Boby Kandathil is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

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

Permanente Medical Group Inc
15 mi
Internal Medicine
710 LAWRENCE EXPRESSWAY
Santa Clara, CA 95051
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1073606299 (408) 851-1000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95139 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $70.37 – $206.04
Typical copayment $0.00 (range $17.59 – $51.51)
Most-billed visit code NA
Established Patient
$86.56 typical visit price
range $23.96 – $169.60
Typical copayment $21.64 (range $5.99 – $42.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Nimy Kandathil's NPI number?

The NPI number for Nimy Kandathil is 1114792454. It was assigned to this individual provider in the NPPES registry on November 16, 2023.

Where is Nimy Kandathil located?

Nimy Kandathil practices at 7196 Alder Spring Way, San Jose, CA 95139. The listed phone number is (832) 475-7626.

What is Nimy Kandathil's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Nimy Kandathil enrolled in Medicare?

Yes. Nimy Kandathil is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Nimy Kandathil's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nimy Kandathil 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 Nimy Kandathil'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 Nimy Kandathil was last updated on November 16, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.