Individual provider Active NPI

Naomi Kovatch, NP

  • Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1043062052
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95028753 Issued in CA
Practice address
Washington Ave S
Minneapolis, MN 55401
Phone
(866) 492-5336
NPI assigned
Apr 3, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95028753 CA Primary

Addresses

Primary practice location

Washington Ave S
Minneapolis, MN 55401

Mailing address

Washington Ave S
Minneapolis, MN 55401
Phone (866) 492-5336

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240514003586 CA Practitioner - Nurse Practitioner 6507207131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Uci Department of UrologyGroup PAC ID 6901799238, 51 clinicians

Practice addresses (Care Compare)

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-6054

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95028753CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Uci Department of Urology CurrentSince Jun 3, 2024 Accepting new patients
University of California Irvine Past Accepting new patients

Locations

19200 Jamboree Rd
Ste 5100
Irvine, CA 92612
Phone (888) 268-1108

20350 SW Birch St
Newport Beach, CA 92660
Phone (714) 415-7017

20350 SW Birch St
Ste 210
Newport Beach, CA 92660
Phone (714) 456-7005

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1712102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1043062052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "WASHINGTON AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55401",
            "telephone_number": "866-492-5336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WASHINGTON AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55401",
            "telephone_number": "866-492-5336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVATCH",
        "first_name": "NAOMI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-03",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95028753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.