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DIVYA MOODALBAIL
NPI 1720265929
Pediatrics - Pediatric Nephrology in Santa Clara, CA

Active since January 30, 2008PECOS Enrolled
710 LAWRENCE EXPY, SANTA CLARA, CA 95051(408) 851-1240(408) 851-1240 Get Directions Write a Review

NPPES record last updated: January 10, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 10, 2022, Mar 8, 2021 (2 updates tracked since 2021).

About Divya Moodalbail NPPES

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

DIVYA MOODALBAIL (NPI 1720265929) is an individual pediatric nephrology provider in Santa Clara, California, licensed in California (CA) and active in the NPI registry since January 2008. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1720265929
Entity TypeIndividualFemale
Primary Taxonomy2080P0210X
Provider Legal NameDIVYA MOODALBAIL
Location Address710 LAWRENCE EXPYSanta Clara, CA 95051-5173
Mailing Address710 Lawrence ExpySanta Clara, CA 95051-5173
Phone(408) 851-1240
Fax(408) 851-1240
Sole ProprietorNo
Enumeration DateJanuary 30, 2008
Last NPPES UpdateJanuary 10, 20222 updates tracked since enumeration
NPPES CertifiedMarch 8, 2021
✔ NPI 1720265929 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0210X
License✔ Licensed in CA · CA
Definition
A pediatrician who deals with the normal and abnormal development and maturation of the kidney and urinary tract, the mechanisms by which the kidney can be damaged, the evaluation and treatment of renal diseases, fluid and electrolyte abnormalities, hypertension and renal replacement therapy.
710 LAWRENCE EXPY, Santa Clara, CA 95051
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Other Names 1

Other Name (5)Divya Moodalbail Md

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Divya Moodalbail 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 Divya Moodalbail reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc
0.1 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.

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.

MRS. SHARLENE JUNIO MADANES N.P.
Nurse Practitioner (Family)
710 LAWRENCE EXPY
SANTA CLARA, CA 95051
Santa Clara County (408) 851-3829
ELLEN CHINCHILLI MD
Student in an Organized Health Care Education/Training Program
710 LAWRENCE EXPY
SANTA CLARA, CA 95051
Santa Clara County (408) 851-3817
SWARNA L KONERU RD
Dietitian, Registered
710 LAWRENCE EXPY
SANTA CLARA, CA 95051
Santa Clara County (408) 851-1000
MRS. BRIDGET M. BOUYSSOUNOUSE P.T.
Physical Therapist
710 LAWRENCE EXPY, DEPT. #174
SANTA CLARA, CA 95051
Santa Clara County (408) 851-1466
FLAIR D. GOLDMAN DPM
Podiatrist
710 LAWRENCE EXPY
SANTA CLARA, CA 95051
Santa Clara County (408) 236-6400
MR. KRISNA P CHAI M.D.
Internal Medicine (Gastroenterology)
710 LAWRENCE EXPY
SANTA CLARA, CA 95051
Santa Clara County (408) 851-1000
KARISSA TAAN MPT
Physical Therapist
710 LAWRENCE EXPY
SANTA CLARA, CA 95051
Santa Clara County (408) 851-1492
ANDREA B. HUTCHINSON MD
Obstetrics & Gynecology
710 LAWRENCE EXPY
SANTA CLARA, CA 95051
Santa Clara County (408) 851-1000

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 Divya Moodalbail's NPI number?

The NPI number for Divya Moodalbail is 1720265929. It was assigned to this individual provider in the NPPES registry on January 30, 2008. The provider is also known as Divya Moodalbail MD.

Where is Divya Moodalbail located?

Divya Moodalbail practices at 710 Lawrence Expy, Santa Clara, CA 95051. The listed phone number is (408) 851-1240.

What is Divya Moodalbail's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Nephrology, with taxonomy code 2080P0210X.

Is Divya Moodalbail enrolled in Medicare?

Yes. Divya Moodalbail is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Divya Moodalbail's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Divya Moodalbail 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 Divya Moodalbail'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 Divya Moodalbail was last updated on January 10, 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.