Individual provider Active NPI

Russell Paul Knittel, MD

  • Emergency Medicine Physician
  • Redondo Beach, CA
National Provider Identifier
1861421711
Registry record updated Apr 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A72017 Issued in CA
Practice address
1812 Artesia Blvd
Redondo Beach, CA 90278-2906
Phone
(310) 374-5600
Fax
(310) 374-5602
NPI assigned
Jul 2, 2006
Last updated
Apr 6, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A72017 CA Primary

Addresses

Primary practice location

1812 Artesia Blvd
Redondo Beach, CA 90278-2906

Mailing address

1812 Artesia Blvd
Redondo Beach, CA 90278-2906
Phone (310) 374-5600

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
I20100503000157 CA Practitioner - Emergency Medicine 8022146646 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of California, Davis School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1812 Artesia Blvd
Redondo Beach, CA 90278-2906
Phone (310) 374-5600

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Paul Knittel MD Inc CurrentSince Sep 7, 2013 Accepting new patients

Locations

1812 Artesia Blvd
Redondo Beach, CA 90278
Phone (310) 374-5600

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396742400000",
    "number": "1861421711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 ARTESIA BLVD",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902782906",
            "telephone_number": "310-374-5600",
            "fax_number": "310-374-5602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 ARTESIA BLVD",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902782906",
            "telephone_number": "310-374-5600",
            "fax_number": "310-374-5602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNITTEL",
        "first_name": "RUSSELL",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2014-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A72017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

Verify at the official NPI Registry.