NPIMap

Individual provider Active NPI

Patric Timothy Knecht, M.D.

  • Family Medicine Physician
  • East Patchogue, NY
National Provider Identifier
1376078717
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
301929 Issued in NY
Practice address
285 Sills Rd BLDG 12
East Patchogue, NY 11772-4869
Phone
(631) 638-1750
Fax
(631) 678-1761
NPI assigned
Apr 24, 2017
Last updated
Jun 30, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 301929 NY Primary

Addresses

Primary practice location

285 Sills Rd BLDG 12
East Patchogue, NY 11772-4869

Mailing address

PO Box 1559
Stony Brook, NY 11790-0989
Phone (631) 638-1750

Other practice location 1

1025 Pennock Place
Family Medicine Center
Fort Collins, CO 80524
Phone (970) 495-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20230825000653 CO Practitioner - Family Practice 4284908633 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aspen Valley Hospital DistrictGroup PAC ID 9234123266, 38 clinicians

Practice addresses (Care Compare)

1460 E Valley Rd
Suite 103
Basalt, CO 81621-8412
Phone (970) 544-1120

401 Castle Creek Rd
Aspen, CO 81611-1159
Phone (970) 925-1120

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.89 of 100Reported as apm
Quality
86.88
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aspen Valley Hospital Clinics, PLLC Family Medicine Current Accepting new patients
Aspen Valley Hospital District Clinics CurrentSince Sep 5, 2023 Accepting new patients
Aspen Valley Hospital District CurrentSince Sep 5, 2023 Accepting new patients
Aspen Valley Hospital District CurrentSince Dec 7, 2025 Accepting new patients
Aspen Valley Hospital District CurrentSince Sep 5, 2023 Accepting new patients
Poudre Valley Health Care,Inc Past Accepting new patients
Poudre Valley Health Care Inc Past Accepting new patients

Locations

401 Castle Creek Rd
Aspen, CO 81611
Phone (970) 544-1192

1460 E Valley Rd
Ste 103
Basalt, CO 81621
Phone (970) 279-4111

Interoperability endpoints

  • FHIR API: https://epicproxy.et1254.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 7

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 6

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": "1492992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1376078717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1559",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900989",
            "telephone_number": "631-638-1750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 SILLS RD BLDG 12",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724869",
            "telephone_number": "631-638-1750",
            "fax_number": "631-678-1761"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1025 Pennock Place",
            "address_2": "Family Medicine Center",
            "address_purpose": "LOCATION",
            "city": "Fort Collins",
            "state": "CO",
            "postal_code": "80524",
            "country_code": "US",
            "telephone_number": "970-495-8800",
            "fax_number": "970-495-8891",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNECHT",
        "first_name": "PATRIC",
        "middle_name": "TIMOTHY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-24",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "301929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Patchogue, NY

Sources for this page

Verify at the official NPI Registry.