| Mr Stephen John Knoble, PA-C | |
|
608 E Garfield Ave, Gettysburg, SD 57442-1325 | |
| (605) 765-2273 | |
| (605) 765-2273 |
| Full Name | Mr Stephen John Knoble |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 19 Years |
| Location | 608 E Garfield Ave, Gettysburg, South Dakota |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245230937 | NPI | - | NPPES |
| S6960 | Other | SD | BCBS GROUP # |
| 57584 | Other | SD | MEDICARE B INDIVIDUAL # |
| 4997560 | Other | SD | INDIVIDUAL BCBS |
| 4997849 | Other | SD | GROUP BCBS |
| 5350190 | Medicaid | SD | |
| 6822152 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | 0290 (South Dakota) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Avera @ Home | Pierre, SD | Home health agency |
| Avera St Mary's Hospital | Pierre, SD | Hospital |
| Avera Missouri River Health Center | Gettysburg, SD | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Rural Health Care Inc | 3476447541 | 156 |
| Avera Gettysburg | 4284619362 | 12 |
| Entity Name | Rural Health Care Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1720076441 PECOS PAC ID: 3476447541 Enrollment ID: O20040210000648 |
| Entity Name | Avera St Marys |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669457180 PECOS PAC ID: 0143134965 Enrollment ID: O20040225000579 |
| Entity Name | Avera Gettysburg |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1003887266 PECOS PAC ID: 4284619362 Enrollment ID: O20061104000319 |
| Entity Name | Avera Gettysburg |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1366091357 PECOS PAC ID: 4284619362 Enrollment ID: O20191025000756 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Stephen John Knoble, PA-C 306 S Broadway St, Gettysburg, SD 57442-1506 Ph: (605) 765-2790 | Mr Stephen John Knoble, PA-C 608 E Garfield Ave, Gettysburg, SD 57442-1325 Ph: (605) 765-2273 |
Mr. Ethan David Burdman, PA-C, MPAS Physician Assistant Medicare: Medicare Enrolled Practice Location: 608 E Garfield Ave, Gettysburg, SD 57442 Phone: 605-765-2273 Fax: 605-765-3212 |