NPIMap

Individual provider Active NPI

Mark Alan Novack, MD

  • Internal Medicine Physician
  • Chesterfield, MO
National Provider Identifier
1114918737
Registry record updated Dec 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
R6535 Issued in MO
Practice address
224 South Woods Mill Rd
Chesterfield, MO 63017
Phone
(314) 878-7220
Fax
(314) 878-0047
NPI assigned
Nov 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R6535 MO Primary

Addresses

Primary practice location

224 South Woods Mill Rd
Chesterfield, MO 63017

Mailing address

224 South Woods Mill Rd
Chesterfield, MO 63017
Phone (314) 878-7220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100505000533 MO Practitioner - Internal Medicine 4284790148 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Washington University School of Medicine, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Woods Mill Medical Associates, LLCGroup PAC ID 0749441830, 6 clinicians

Practice addresses (Care Compare)

224 S Woods Mill Rdste 435
Chesterfield, MO 63017-3493
Phone (314) 576-2394

Hospital & facility affiliations

  • St Luke'S Home Health Services Home health agency, Chesterfield, MO, CCN 267561
  • FV at Home by Friendship Village Home health agency, Chesterfield, MO, CCN 267599
  • St Lukes Hospital Hospital, Chesterfield, MO, CCN 260179
  • Barnes-Jewish West County Hospital Hospital, Creve Coeur, MO, CCN 260162
  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
  • SSM Health Rehabilitation Hospital Inpatient rehabilitation facility, Richmond Heights, MO, CCN 263031

Merit-based Incentive Payment System (MIPS)

Final score
92.71 of 100Reported as apm
Quality
82.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Woods Mill Medical Associates, LLC Internal Medicine CurrentSince Aug 20, 2014 Accepting new patients
Diagnostic Internists, Inc Internal Medicine PastSince Oct 1, 1985 Accepting new patients
St. Lukes Medical Group Internal Medicine Past Accepting new patients

Locations

224 S Woods Mill Rd
Ste 435S
Chesterfield, MO 63017
Phone (314) 392-4762

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323129600000",
    "number": "1114918737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 SOUTH WOODS MILL RD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "63017",
            "telephone_number": "314-878-7220",
            "fax_number": "314-878-0047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 SOUTH WOODS MILL RD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "63017",
            "telephone_number": "314-878-7220",
            "fax_number": "314-878-0047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVACK",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2011-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "R6535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.