Charles I. Knoll, M.D.
Individual provider Active NPI Physical Medicine & Rehabilitation Physician · Rancho Mirage, CA
NPI 1962443945 · NPPES record last updated Nov 5, 2021
Key facts
- NPI
- 1962443945
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Medicine & Rehabilitation Physician 208100000X
- License
- A100046 (CA)
- Practice address
- 39000 Bob Hope Dr
Annenberg 2 West
Rancho Mirage, CA 92270-3221 - Phone
- (760) 834-7870
- Fax
- (760) 834-7871
- NPI assigned
- Jun 9, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 8
Owned or controlled facilities with NPI records 1
Medicare Care Compare profile
- Specialty
- Physical Medicine and Rehabilitation
- Education
- Virginia Commonwealth University, School of Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Providence Medical Foundation
Practice addresses (Care Compare)
2700 Dolbeer St
Eureka, CA 95501-4736
Phone (707) 445-8121
Hospital & facility affiliations
- Hospice of Humboldt, Inc.
- Providence St Joseph Hospital
- Santa Rosa Memorial Hospital
- Fortuna Rehabilitation and Wellness Center, LP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Hospice of Humboldt, Inc. |
Hospice | W-2 Managing Employee (5%) | Dec 1, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081212000270 | CA | Practitioner - Physical Medicine and Rehabilitation | 7416040860 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Medical Foundation | Current | Accepting new patients | |
| Hospice of Humboldt Inc | Current |
Accepting new patients | |
| Providence Medical Foundation | Current |
Accepting new patients | |
| Providence Medical Foundation | Current |
Accepting new patients | |
| Eisenhower Medical Center | Past | Accepting new patients |
Locations
2700 Dolbeer St
Eureka, CA 95501
Phone (707) 269-4229
3327 Timber Fall Ct
Eureka, CA 95503
Phone (707) 445-8443
500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842
1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210
Interoperability endpoints
- cknoll1657912@oc.providencedirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | MD27724 | OR | |
| Physical Medicine & Rehabilitation Physician | 208100000X | A100046 | CA | Yes |
Addresses
Primary practice location
39000 Bob Hope Dr
Annenberg 2 West
Rancho Mirage, CA 92270-3221
Mailing address
39000 Bob Hope Dr
Annenberg 2 West
Rancho Mirage, CA 92270-3221
Phone (760) 834-7870
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 403418000 | Medicaid | MD |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | cknoll1657912@oc.providencedirect.org |
Other providers in Rancho Mirage, CA
- Alan H. Kiselstein
- Brittany Klatil
- Klaus M. Yi, D.D.S, Inc.
- Geraldine Theresa Klein
- Rosie Knauf
- David B Ko
- Hong-Ki Samuel Ko
- Janice M. Koehler
- Sin Wee Koh-Gale
- Jeffrey Dean Kohfeld
All providers in Rancho Mirage, CA · Physical Medicine & Rehabilitation Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 5, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.