Individual provider Active NPI

Samar Novak, APRN

  • Nurse Practitioner
  • Fayetteville, AR
National Provider Identifier
1114558996
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
123709 Issued in AR
Practice address
3215 N Northhills Blvd
Fayetteville, AR 72703-4424
Phone
(497) 463-8740
NPI assigned
Jan 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 123709 AR Primary

Addresses

Primary practice location

3215 N Northhills Blvd
Fayetteville, AR 72703-4424

Mailing address

3215 N Northhills Blvd
Fayetteville, AR 72703-4424
Phone (479) 463-8740

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20200430000073 AR Practitioner - Nurse Practitioner 4183054398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington Regional Medical SystemGroup PAC ID 8820995434, 238 clinicians

Practice addresses (Care Compare)

3211 N N Hills Blvd
Suite 110
Fayetteville, AR 72703-5602
Phone (479) 571-4338

Hospital & facility affiliations

  • Washington Regional Medical Center Hospital, Fayetteville, AR, CCN 040004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Regional Medical System CurrentSince May 1, 2020 Accepting new patients
Washington Regional Medical System CurrentSince May 1, 2020 Accepting new patients

Locations

3215 N Northhills Blvd
Fayetteville, AR 72703
Phone (479) 463-1000

114 E Sunbridge Dr
Fayetteville, AR 72703
Phone (479) 463-2597

3211 N Northhills Blvd
Ste 110
Fayetteville, AR 72703
Phone (479) 571-4338

Interoperability endpoints

  • Direct secure messaging: snovak36593@washingtonregional.direct-ci.com

Organizations & group practices 2

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": "1580342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1114558996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3215 N NORTHHILLS BLVD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034424",
            "telephone_number": "479-463-8740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3215 N NORTHHILLS BLVD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034424",
            "telephone_number": "497-463-8740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVAK",
        "first_name": "SAMAR",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-30",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "123709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.