Mariel Novacek

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

9538 Issued in MN

Practice address

120 1St St S
Buffalo, MN 55313-1402

Phone

(612) 756-9757

NPI assigned

Jul 18, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Optimal Function

  • Physical Medicine & Rehabilitation Physician
  • Buffalo, MN
  • NPI 1881208981
  NPD Authorized official

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

{
    "created_epoch": "1468800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1124471875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1606 PULASKI RD",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553132228",
            "telephone_number": "612-702-1542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 1ST ST S",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553131402",
            "telephone_number": "612-756-9757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVACEK",
        "first_name": "MARIEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-18",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "13595",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "9538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brett Nikula, LMFT
• Monica Marie Nord, LADC
• Steven Norman, PA-C
• Amanda Norris, D.O.
• Novacare Outpatient Rehabilitation East, Inc.
• Jess Nowak Jr.
• Josiah Nunemaker, ATR
• Michael Dean O'Borsky, D.P.M.
• Sally J O'Borsky, PT
• John Daniel O'Donnell, DC

• Physical Therapist in Buffalo, MN
• Providers in Buffalo, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2020; 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.