MR. HENRY IV KNOOP (RPA-C) – Medical Physician Assistant, NPI 1790912152

MR. HENRY IV KNOOP (RPA-C) is a healthcare provider. based in Lakeport, California. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials RPA-C. They hold a License No. 085003747 (IL). The NPI Number for MR. HENRY IV KNOOP (RPA-C) is 1790912152

Main info

Male
Sole Proprietor
18 Years Of Experience
Accepts Medicare Assignment
Name
MR. HENRY IV KNOOP (RPA-C)
NPI
1790912152
Phone
(707) 262-5088
Address
5176 HILL RD E
Enumeration Date
12 June 2009
Last Update Date
15 February 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5182543456
Graduation Year
2008 (18 years ago)
PAC ID
6204028343
Group Practice PAC ID
3779488325
Professional Enrollment ID
I20180726002415
Address ID
NY120435144CO178XXDRXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience79
Completeness75
Years active:16State licenses:3Digital endpointsOther names

10,570 PHYSICIAN ASSISTANT in CA

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Provider Addresses for MR. HENRY IV KNOOP (RPA-C)

  • Sutter Lakeside Hospital, 5176, Hill Road East, Lakeport, Lake County, California, 95453, United States

    LAKEPORT, CA 954536300

    Phone: (707) 262-5088

    Fax: (707) 263-8977

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-07-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180726002415IPhysician AssistantNYTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 95453)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3779488325View full group profile

Reviews

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Frequently asked questions

What identifier follows MR. HENRY IV KNOOP (RPA-C) across health systems?
The NPI 1790912152 uniquely identifies MR. HENRY IV KNOOP (RPA-C) in U.S. healthcare data.
Does the public listing show MR. HENRY IV KNOOP (RPA-C) as active?
MR. HENRY IV KNOOP (RPA-C)'s NPI record reflects an active status in NPPES.
Which specialty label fits MR. HENRY IV KNOOP (RPA-C)?
NPPES ties MR. HENRY IV KNOOP (RPA-C) to Medical Physician Assistant in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to MR. HENRY IV KNOOP (RPA-C)?
The directory associates MR. HENRY IV KNOOP (RPA-C) with Lakeport, California. Check all listed addresses for suites or satellite offices.
Who maintains MR. HENRY IV KNOOP (RPA-C)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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