NPIMap

Individual provider Active NPI

Mark E Knoble, M.D.

  • Family Medicine Physician
  • Auburn, CA
National Provider Identifier
1174617799
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G77414 Issued in CA
Practice address
3288 Bell Rd
Auburn, CA 95603-9243
Phone
(530) 886-2300
Fax
(530) 886-2301
NPI assigned
Oct 3, 2006
Last updated
Aug 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G77414 CA Primary

Addresses

Primary practice location

3288 Bell Rd
Auburn, CA 95603-9243

Mailing address

PO Box 255228
Sacramento, CA 95865-5228

Other identifiers 1

IdentifierTypeStateIssuer
00G774140MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081113000648 CA Practitioner - Family Practice 1658431192 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, Geffen School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

2800 L St
Sacramento, CA 95816-5616

3288 Bell Rd
Auburn, CA 95603-9243
Phone (530) 886-2300

3320 Bell Rd
Auburn, CA 95603-9243
Phone (530) 888-1266

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G77414CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Newstart Medical Group Inc CurrentSince Jun 19, 2022 Accepting new patients
Vital Health Ca Medical Group Family Medicine CurrentSince Dec 1, 2022 Accepting new patients
Sutter Regional Medical Foundation Family Medicine Past Accepting new patients

Locations

4944 Windplay Dr
Ste 112
El Dorado Hills, CA 95762
Phone (202) 309-9677

11386 Pleasant Valley Rd
Penn Valley, CA 95946
Phone (530) 451-6234

Interoperability endpoints

  • Direct secure messaging: mknoblemdsmf34963@hisp.ehr.sutterhealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1174617799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255228",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958655228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3288 BELL RD",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956039243",
            "telephone_number": "530-886-2300",
            "fax_number": "530-886-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOBLE",
        "first_name": "MARK",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G77414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G774140",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, CA

Sources for this page

Verify at the official NPI Registry.