MICHAEL KNOBELOCH (PSY.D.) – Clinical Psychologist, NPI 1619396736
Clinical Psychologist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,600 CLINICAL PSYCHOLOGIST in IL
Provider Addresses for MICHAEL KNOBELOCH (PSY.D.)
102 W KENWOOD AVE
SUITE 120A
DECATUR, IL 625264368
Phone: (309) 706-3190
Fax: (309) 588-4115
Type: Location
PO BOX 604
BLOOMINGTON, IL 617020604
Phone: (309) 706-3190
Fax: (309) 588-4115
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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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: 2016-07-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20151027003117 | I | Clinical Psychologist | IL | TBD |
| I20160726002594 | I | Clinical Psychologist | MO | TBD |
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.
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 62526)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PSYCHOLOGIST, CLINICAL | IL | 96118 | Neuropsychological testing, interpretation, and report by psychologist or physician per hour | 88 | 12 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MO | |
| Clinical Psychologist | MO | |
| Clinical Social Worker | MO | |
| Clinical Psychologist | SC | |
| - | MO | |
| P S Y C H I A T R Y | MO | |
| Clinical Psychologist | MO | |
| Clinical Social Worker | MO | |
| - | MO | |
| Clinical Social Worker | MO |
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