Individual provider Active NPI

William Koble, M.D.

  • Family Medicine Physician
  • Placerville, CA
National Provider Identifier
1558367102
Registry record updated Dec 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G76138 Issued in CA
Practice address
4341 Golden Center Dr
Suite B
Placerville, CA 95667-6260
Phone
(530) 621-3600
NPI assigned
Jun 27, 2005
Last updated
Dec 18, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2013

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 G76138 CA Primary

Addresses

Primary practice location

4341 Golden Center Dr
Suite B
Placerville, CA 95667-6260

Mailing address

PO Box 45680
San Francisco, CA 94145-0680
Phone (530) 621-3600

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
I20080918000220 CA Practitioner - Family Practice 3476620378 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Southern California Keck School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marshall Medical CenterGroup PAC ID 7517875859, 168 clinicians

Practice addresses (Care Compare)

1095 Marshall Way
Placerville, CA 95667-5722

3581 Palmer Dr
Suite 602
Cameron Park, CA 95682-8238
Phone (530) 672-7000

4201 Town Ctr Blvd
BLDG D
El Dorado Hills, CA 95762-7100
Phone (916) 905-6378

4341 Golden Ctr Dr
Placerville, CA 95667-6260
Phone (530) 626-1144

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions38
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G76138CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marshall Medical Center Family Medicine CurrentSince Feb 26, 2010 Accepting new patients
Marshall Medical Center CurrentSince Feb 26, 2010 Accepting new patients
Marshall Medical Center Past Accepting new patients
Mdstat Urgent Care, Inc Past Accepting new patients
Marshall Medical Center Past Accepting new patients

Locations

3581 Palmer Dr
Ste 602
Cameron Park, CA 95682
Phone (530) 626-2920

1095 Marshall Way
Ste 201
Placerville, CA 95667
Phone (530) 344-5470

4341 Golden Center Dr
Bldg B
Placerville, CA 95667

4341 Golden Center Dr
Ste B
Placerville, CA 95667
Phone (530) 621-3600

Organizations & group practices 5

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 4

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": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387324800000",
    "number": "1558367102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 45680",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941450680",
            "telephone_number": "530-621-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4341 GOLDEN CENTER DR",
            "address_2": "SUITE B",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956676260",
            "telephone_number": "530-621-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBLE",
        "first_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2013-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G76138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Placerville, CA

Sources for this page

Verify at the official NPI Registry.