NPIMap

Individual provider Active NPI

Mary Elizabeth Novak, DO

  • Urology Physician
  • Philadelphia, PA
National Provider Identifier
1043771694
Registry record updated Jan 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
OS024746 Issued in PA
Practice address
3509 N Broad St
Philadelphia, PA 19140-4105
Phone
(215) 707-3375
NPI assigned
Mar 27, 2019
Last updated
Jan 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 4292 WV
Urology Physician 208800000X OS024746 PA Primary

Addresses

Primary practice location

3509 N Broad St
Philadelphia, PA 19140-4105

Mailing address

3509 N Broad St
Philadelphia, PA 19140-4105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, PA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240806004648 WV Practitioner - Urology 7517297526 Reassigns benefits to 3 organizations
I20250529004253 PA Practitioner - Urology 7517297526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Edward Via Col of Osteo Medicine-Virginia Campus, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

8 Huntingdon Pike
Rockledge, PA 19046-4351
Phone (215) 214-3269

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS024746PAMDUrology Physician
4292WVMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Preston Memorial Hospital Corporation CurrentSince Aug 5, 2024 Accepting new patients
Temple Faculty Practice Plan Inc Urology CurrentSince Jun 1, 2025 Accepting new patients
Monongalia County General Hospital Company CurrentSince Aug 5, 2024 Accepting new patients
Stonewall Jackson Memorial Hospital Company CurrentSince Aug 5, 2024 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Jun 1, 2025 Accepting new patients
Preston Memorial Hospital Corporation CurrentSince Aug 5, 2024 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Stonewall Jackson Memorial Hospital Company CurrentSince Aug 5, 2024 Accepting new patients

Locations

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

3500 N Broad St
#1A
Philadelphia, PA 19140

3509 N Broad St
Philadelphia, PA 19140
Phone (215) 707-2433

8 Huntingdon Pike
Rockledge, PA 19046
Phone (215) 214-3269

150 Memorial Dr
Kingwood, WV 26537
Phone (304) 329-4701

1000 J D Anderson Dr
Ste 401
Morgantown, WV 26505
Phone (304) 598-2906

1200 J D Anderson Dr
Morgantown, WV 26505
Phone (304) 598-1460

230 Hospital Plz
Weston, WV 26452
Phone (304) 269-8000

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/preston-adacdb24

Organizations & group practices 8

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 10

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": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1043771694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3509 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3509 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404105",
            "telephone_number": "215-707-3375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVAK",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-27",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WV",
            "license": "4292",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "PA",
            "license": "OS024746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.