Active NPI
Koko Novak, MD
- Obstetrics & Gynecology Physician
- Ann Arbor, MI
National Provider Identifier
1043949811
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 4351052660
- Practice address
- 2752 Page Ave
Ann Arbor, MI 48104-6914 - Phone
- (801) 518-9800
- NPI assigned
- Jun 7, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 4351052660 | MI | Primary |
Addresses
Primary practice location
2752 Page Ave
Ann Arbor, MI 48104-6914
Mailing address
2752 Page Ave
Ann Arbor, MI 48104-6914
Phone (801) 518-9800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- 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 |
|---|---|---|---|---|
| I20240703003502 | MI | Order and Referring Only - Obstetrics/Gynecology | 3678017472 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719187200000",
"number": "1043949811",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2752 PAGE AVE",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481046914",
"telephone_number": "801-518-9800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2752 PAGE AVE",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481046914",
"telephone_number": "801-518-9800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOVAK",
"first_name": "KOKO",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-06-07",
"last_updated": "2024-06-24",
"certification_date": "2024-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "MI",
"license": "4351052660",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; 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.