Mark M Novotny, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT001945 Issued in GA

Practice address

535 Jesse Jewell Pkwy SE
Suite C
Gainesville, GA 30501-3772

Phone

(770) 534-1711

NPI assigned

Dec 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gainesville Eye Associates LLCGroup PAC ID 2860486438, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mnovotny@esp.intellechartdirect.net

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.

• Gainesville Eye Associates LLC

  • Ophthalmology Physician
  • Gainesville, GA
  • NPI 1285617647

  Optometrist

  Medicare reassignment Care Compare group NPD
• Gainesville Eye Associates LLC

  • Ophthalmology Physician
  • Braselton, GA
  • NPI 1821875774

  Optometrist

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063574176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 JESSE JEWELL PKWY SE",
            "address_2": "SUITE C",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013772",
            "telephone_number": "770-534-1711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 JESSE JEWELL PKWY SE",
            "address_2": "SUITE C",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013772",
            "telephone_number": "770-534-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVOTNY",
        "first_name": "MARK",
        "middle_name": "M",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT001945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00922501A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northland Hearing Centers, Inc
• Northside Hospital, Inc.
• Northside Hospital, Inc.
• Northwest Diagnostic Imaging, Inc
• Bethany Rennaye Norwood, FNP-C
• Numind Wellness LLC
• Valerie Lisette Nunez
• Nunova Health LLC
• Gillian C.J. Nurhonen, OTRL
• Ndidiamaka Onyeanwuli Nwaka, M.D

• Optometrist in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Optometrist in Georgia

• 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.