Individual provider Active NPI

Michael-Alice Moga, MD

  • Pediatric Critical Care Medicine Physician
  • Palo Alto, CA
National Provider Identifier
1790992808
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
C198653 Issued in CA
Practice address
725 Welch Rd
Palo Alto, CA 94304-1601
Phone
(650) 497-8000
NPI assigned
May 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X C198653 CA
Pediatric Cardiology Physician 2080P0202X 35.086776 OH
Pediatric Cardiology Physician 2080P0202X C198653 CA
Pediatric Critical Care Medicine Physician 2080P0203X 35.086776 OH
Pediatric Critical Care Medicine Physician 2080P0203X C198653 CA Primary

Addresses

Primary practice location

725 Welch Rd
Palo Alto, CA 94304-1601

Mailing address

725 Welch Rd
Palo Alto, CA 94304-1601
Phone (650) 497-8000

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
I20241028002439 CA Practitioner - Pediatric Medicine 7911150107 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C198653CAMDPediatrics Physician
35.086776OHMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stanford Health Care CurrentSince Oct 23, 2024 Accepting new patients
LPCH Medical Group Div of Lucile Pediatrics CurrentSince Oct 23, 2024 Accepting new patients
Stanford Health Care Pediatrics CurrentSince Oct 23, 2024 Accepting new patients
Stanford Health Care Pediatrics Current Accepting new patients

Locations

725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979

725 Welch Rd
#D
Palo Alto, CA 94304

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

Organizations & group practices 4

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": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1790992808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 WELCH RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041601",
            "telephone_number": "650-497-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 WELCH RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041601",
            "telephone_number": "650-497-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGA",
        "first_name": "MICHAEL-ALICE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "C198653",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "OH",
            "license": "35.086776",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "CA",
            "license": "C198653",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "OH",
            "license": "35.086776",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "CA",
            "license": "C198653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.