Active NPI
Peter J Novak, MD
- Orthopaedic Surgery Physician
- Salt Lake City, UT
National Provider Identifier
1104818608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 294852-1205
- Practice address
- 1160 E 3900 S Ste 5000
Salt Lake City, UT 84124-1275 - Phone
- (801) 261-7479
- Fax
- (801) 261-7429
- NPI assigned
- Aug 19, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 294852-1205 | UT | Primary |
Addresses
Primary practice location
1160 E 3900 S Ste 5000
Salt Lake City, UT 84124-1275
Mailing address
PO Box 100253
Atlanta, GA 30384-0253
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0022269 | Medicaid | UT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Orthopedic Surgery
- Education
- University of Utah School of Medicine, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1160 E 3900 S
Suite 5000
Salt Lake City, UT 84124-1275
Hospital & facility affiliations
- True North Home Health
- St Mark'S Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Hip replacement | 1-10 |
| Knee replacement | 1-10 |
| Lower limb (leg) arthroscopy (minimally invasive joint repair) | 1-10 |
| Upper limb (arm) arthroscopy (minimally invasive joint repair) | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Salt Lake City, UT
- NPI 1164469243
-
- Home Health Agency
- South Salt Lake, UT
- NPI 1851303390
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588809600000",
"number": "1104818608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 100253",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303840253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1160 E 3900 S STE 5000",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841241275",
"telephone_number": "801-261-7479",
"fax_number": "801-261-7429"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOVAK",
"first_name": "PETER",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-19",
"last_updated": "2020-05-07",
"certification_date": "2020-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "UT",
"license": "294852-1205",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0022269",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2020; 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.