Active NPI
Frederick George Novy, MD
- Dermatology Physician
- Morro Bay, CA
National Provider Identifier
1013026202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- G48373
- Practice address
- 895 Shasta Ave
Morro Bay, CA 93442 - Phone
- (805) 772-1233
- Fax
- (805) 772-5226
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | G48373 | CA | Primary |
Addresses
Primary practice location
895 Shasta Ave
Morro Bay, CA 93442
Mailing address
895 Shasta Ave
Morro Bay, CA 93442
Phone (805) 772-1233
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101230000701 | CA | Practitioner - Dermatology | 8729276084 | Practice locations: Morro Bay, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48373 | CA | MD | General Practice Dentistry |
| G48373 | CA | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013026202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "895 SHASTA AVE",
"city": "MORRO BAY",
"state": "CA",
"postal_code": "93442",
"telephone_number": "805-772-1233",
"fax_number": "805-772-5226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "895 SHASTA AVE",
"city": "MORRO BAY",
"state": "CA",
"postal_code": "93442",
"telephone_number": "805-772-1233",
"fax_number": "805-772-5226"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOVY",
"first_name": "FREDERICK",
"middle_name": "GEORGE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CA",
"license": "G48373",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Morro Bay, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.