Individual provider Active NPI

Carolyn Novak, O.D.

  • Optometrist
  • Center Valley, PA
National Provider Identifier
1093022394
Registry record updated Jun 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG002378 Issued in PA
Practice address
3060 Center Valley Pkwy
Suite 822
Center Valley, PA 18034-9036
Phone
(610) 791-0672
Fax
(601) 791-0713
NPI assigned
Sep 8, 2010
Last updated
Jun 1, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG002378 PA Primary

Addresses

Primary practice location

3060 Center Valley Pkwy
Suite 822
Center Valley, PA 18034-9036

Mailing address

29 Rose St
Forty Fort, PA 18704-4327

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG002378PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Luxottica of America Inc. PastSince Dec 26, 2017 Accepting new patients
Marc Berson and Monica Martocci LLP Optometrist Past Accepting new patients
Dr Martocci and Associates, LLC Optometrist PastSince Feb 18, 2018 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1283904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464739200000",
    "number": "1093022394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 ROSE ST",
            "city": "FORTY FORT",
            "state": "PA",
            "postal_code": "187044327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3060 CENTER VALLEY PKWY",
            "address_2": "SUITE 822",
            "city": "CENTER VALLEY",
            "state": "PA",
            "postal_code": "180349036",
            "telephone_number": "610-791-0672",
            "fax_number": "601-791-0713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVAK",
        "first_name": "CAROLYN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-08",
        "last_updated": "2016-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG002378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Center Valley, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.