Individual provider Active NPI

Courtney Erin Moblad-Barlics, MD

  • Pediatrics Physician
  • San Jose, CA
National Provider Identifier
1629236880
Registry record updated May 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A97931 Issued in CA
Practice address
751 S Bascom Ave
San Jose, CA 95128-2604
Phone
(408) 885-2100
NPI assigned
May 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A97931 CA Primary

Addresses

Primary practice location

751 S Bascom Ave
San Jose, CA 95128-2604

Mailing address

PO Box 742502
Los Angeles, CA 90074-2502
Phone (408) 885-5000

Other names 1

  • Courtney Erin Moblad Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150930001291 CA Practitioner - Pediatric MedicinePractitioner - Internal Medicine 8224346960 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A97931CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Pediatrics CurrentSince May 31, 2017 Accepting new patients
Permanente Medical Group Inc Pediatrics Current Accepting new patients
County of Santa Clara Current Accepting new patients
County of Santa Clara CurrentSince Aug 1, 2015 Accepting new patients
County of Santa Clara CurrentSince Aug 1, 2015 Accepting new patients
Permanente Medical Group, Inc CurrentSince May 31, 2017 Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

7475 Camino Arroyo
Gilroy, CA 95020
Phone (408) 852-2400

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

750 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-2320

1993 McKee Rd
San Jose, CA 95116
Phone (408) 254-6320

500 Tully Rd
San Jose, CA 95111
Phone (408) 817-1433

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

Interoperability endpoints

  • Direct secure messaging: cmobladbarlics11146@santaclaravalley.direct-ci.net

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1211500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431475200000",
    "number": "1629236880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742502",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900742502",
            "telephone_number": "408-885-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 S BASCOM AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282604",
            "telephone_number": "408-885-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOBLAD-BARLICS",
        "first_name": "COURTNEY",
        "middle_name": "ERIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-23",
        "last_updated": "2015-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A97931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "MOBLAD",
            "middle_name": "ERIN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.