Individual provider Active NPI

Eric N Novack, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Phoenix, AZ
National Provider Identifier
1003881442
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
29419 Issued in AZ
Practice address
2902 W Agua Fria Fwy Ste 1090
Phoenix, AZ 85027-3970
Phone
(602) 648-5444
Fax
(602) 772-3801
NPI assigned
Feb 21, 2006
Last updated
Jul 26, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 29419 AZ
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 29419 AZ Primary

Addresses

Primary practice location

2902 W Agua Fria Fwy Ste 1090
Phoenix, AZ 85027-3970

Mailing address

PO Box 80217
Phoenix, AZ 85060-0217
Phone (602) 385-2115

Other identifiers 2

IdentifierTypeStateIssuer
3Z3939OtherAZHEALTHNET
789232MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051228000745 AZ Practitioner - Orthopedic Surgery 7911929385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of California, San Francisco School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

20333 N 19TH Ave
Suite 230
Phoenix, AZ 85027-9901
Phone (602) 772-3800

5620 E Bell Rd
Scottsdale, AZ 85254-5950
Phone (602) 385-2115

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Specialists of North America, PLLC Orthopaedic Surgery CurrentSince May 1, 2010 Accepting new patients
Orthopedic Specialists of North America, PLLC Orthopaedic Surgery Current Accepting new patients
Banner Thunderbird Medical Center Past Accepting new patients

Locations

10450 W McDowell Rd
Ste 102
Avondale, AZ 85392
Phone (623) 846-1746

1675 E Melrose St
Unit 101
Gilbert, AZ 85297

2940 E Banner Gateway Dr
Ste 200250
Gilbert, AZ 85234

20333 N 19th Ave
Ste 230
Phoenix, AZ 85027
Phone (480) 707-9504

2902 W Agua Fria Fwy
Ste 1090
Phoenix, AZ 85027
Phone (620) 648-5444

3133 E Camelback Rd
Ste 245
Phoenix, AZ 85016
Phone (602) 631-3161

33300 N 32nd Ave
Ste 320
Phoenix, AZ 85085

20401 N 73rd St
Ste 175
Scottsdale, AZ 85255
Phone (480) 353-0446

5620 E Bell Rd
Scottsdale, AZ 85254
Phone (602) 485-3050

8405 N Pima Center Pkwy
Ste 101
Scottsdale, AZ 85258
Phone (480) 353-0446

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1003881442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80217",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850600217",
            "telephone_number": "602-385-2115",
            "fax_number": "480-418-3323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2902 W AGUA FRIA FWY STE 1090",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850273970",
            "telephone_number": "602-648-5444",
            "fax_number": "602-772-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVACK",
        "first_name": "ERIC",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "29419",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "AZ",
            "license": "29419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "3Z3939",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "789232",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.