Individual provider Active NPI

Bernard Harold Nowacki, MD

  • Orthopaedic Surgery Physician
  • Marion, OH
National Provider Identifier
1003866161
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
35047204 Issued in OH
Practice address
1040 Delaware Ave
Marion, OH 43302-6416
Phone
(740) 383-8070
Fax
(740) 383-3695
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 35047204 OH Primary

Addresses

Primary practice location

1040 Delaware Ave
Marion, OH 43302-6416

Mailing address

# L-3652
Columbus, OH 43260-6453
Phone (740) 383-7927

Other identifiers 1

IdentifierTypeStateIssuer
0488459MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bnowacki11844@direct.ohiohealth.com OhioHealth Physician Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35047204OHMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Joint Operating Company Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1003866161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "# L-3652",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432606453",
            "telephone_number": "740-383-7927",
            "fax_number": "740-383-7942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 DELAWARE AVE",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433026416",
            "telephone_number": "740-383-8070",
            "fax_number": "740-383-3695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWACKI",
        "first_name": "BERNARD",
        "middle_name": "HAROLD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OH",
            "license": "35047204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0488459",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bnowacki11844@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group",
            "address_1": "1040 Delaware Ave",
            "city": "Marion",
            "state": "OH",
            "country_code": "US",
            "postal_code": "433026416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marion, OH

Sources for this page

Verify at the official NPI Registry.