Individual provider Active NPI

Nicholas Anthony Novak, PA-C

  • Physician Assistant
  • Garden City, NY
National Provider Identifier
1053079947
Registry record updated Nov 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
027893 Issued in NY
Practice address
1101 Stewart Ave Ste 100N
Garden City, NY 11530-4892
Phone
(516) 838-8739
NPI assigned
Dec 7, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 027893 NY Primary

Addresses

Primary practice location

1101 Stewart Ave Ste 100N
Garden City, NY 11530-4892

Mailing address

5 Evans LN
Miller Place, NY 11764-2110

Other practice location 1

5 Evans Ln
Miller Place, NY 11764-2110
Phone (631) 834-7627

Other identifiers 1

IdentifierTypeStateIssuer
027893-01OtherNYSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20220824001926 NY Practitioner - Physician Assistant 1456739663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
True North Medical Group PCGroup PAC ID 7012194806, 185 clinicians

Practice addresses (Care Compare)

1728 Sunrise Hwy
Merrick, NY 11566-3745
Phone (516) 992-4700

36 Lincoln Ave
Rockville Centre, NY 11570-5768
Phone (516) 536-2800

444 Merrick Rd
Lynbrook, NY 11563-2460

900 Franklin Ave
Valley Stream, NY 11580-2145
Phone (516) 536-2800

Hospital & facility affiliations

  • Long Island Jewish Medical Center Hospital, New Hyde Park, NY, CCN 330195

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
027893NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
True North Medical Group PC CurrentSince Aug 30, 2022 Accepting new patients
True North Medical Group PC Physician Assistant CurrentSince Aug 30, 2022 Accepting new patients
True North Medical Group PC Past Accepting new patients

Locations

1101 Stewart Ave
Ste 100N
Garden City, NY 11530
Phone (516) 838-8739

444 Merrick Rd
Lynbrook, NY 11563
Phone (516) 536-3800

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

36 Lincoln Ave
Fl 3
Rockville Ctr, NY 11570

36 Lincoln Ave
Fl 2
Rockville Ctr, NY 11570
Phone (516) 766-2176

686 County Road 39A
Southampton, NY 11968
Phone (631) 283-0355

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: nicholasnovak@nslijmedgr.allscriptsdirect.net

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 and National Provider Directory roles.

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": "1638835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1053079947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 EVANS LN",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "117642110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 STEWART AVE STE 100N",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115304892",
            "telephone_number": "516-838-8739"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Evans Ln",
            "address_purpose": "LOCATION",
            "city": "Miller Place",
            "state": "NY",
            "postal_code": "117642110",
            "country_code": "US",
            "telephone_number": "631-834-7627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOVAK",
        "first_name": "NICHOLAS",
        "middle_name": "ANTHONY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-07",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "027893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "027893-01",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

Verify at the official NPI Registry.