Edward B Novak, MD
Individual provider Active NPI Family Medicine Physician · Tyler, MN
NPI 1104870948 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1104870948
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 35176 (MN)
- Practice address
- 240 Willow St
Tyler, MN 56178-0240 - Phone
- (507) 247-5921
- Fax
- (507) 247-5184
- NPI assigned
- May 19, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35176 | MN | Yes |
Addresses
Primary practice location
240 Willow St
Tyler, MN 56178-0240
Mailing address
240 Willow St
Tyler, MN 56178-0240
Phone (507) 247-5921
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00314383 | Medicaid | NY |
Other providers in Tyler, MN
- Jill Marie Jay
- Marcia S Kells
- Richard L Klingler
- Koster Pharmacy
- Lyon-Lincoln Electric Cooperative, Inc.
- Enrico Ocampo
- Amy Lea Reese
- Christopher Stephen Reynolds
- Michelle Reynolds
- Southwest Family Chiropractic P.L.C.
All providers in Tyler, MN · Family Medicine Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.