NPIMap

Individual provider Active NPI

Marlee Irene Novak, MD

  • Family Medicine Physician
  • Perham, MN
National Provider Identifier
1144883570
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
75364 Issued in MN
Practice address
1000 Coney St W
Perham, MN 56573-2102
Phone
(218) 347-1200
NPI assigned
Apr 22, 2019
Last updated
Oct 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X M-15769 ID
Family Medicine Physician 207Q00000X 75364 MN Primary

Addresses

Primary practice location

1000 Coney St W
Perham, MN 56573-2102

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other practice location 1

1038 Northwest Blvd
Coeur D Alene, ID 83814-2249
Phone (208) 620-5210

Other practice location 2

1919 Lincoln Way Ste 315
Coeur D Alene, ID 83814-2527
Phone (208) 625-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20231024001463 MN Practitioner - Family Practice 6901284959 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota, Duluth School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Perham Hospital DistrictGroup PAC ID 2264327766, 40 clinicians

Practice addresses (Care Compare)

1000 Coney St W
Perham, MN 56573-2102
Phone (218) 347-1656

1000 Coney W St
Perham, MN 56573-2102

105 Otter Dr
Ottertail, MN 56571-7040
Phone (218) 367-6111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.39 of 100Reported as group
Quality
91.62
Promoting interoperability
100
Improvement activities
40
Cost
66.36

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Perham Hospital District Family Medicine CurrentSince Oct 9, 2023 Accepting new patients
Perham Hospital District CurrentSince Oct 9, 2023 Accepting new patients
Perham Hospital District Current Accepting new patients
Sanford Clinic North Family Medicine Past Accepting new patients

Locations

1000 Coney St W
Perham, MN 56573
Phone (218) 347-1200

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1555891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1144883570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 CONEY ST W",
            "city": "PERHAM",
            "state": "MN",
            "postal_code": "565732102",
            "telephone_number": "218-347-1200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1038 Northwest Blvd",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838142249",
            "country_code": "US",
            "telephone_number": "208-620-5210",
            "fax_number": "844-803-7399",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1919 Lincoln Way Ste 315",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838142527",
            "country_code": "US",
            "telephone_number": "208-625-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOVAK",
        "first_name": "MARLEE",
        "middle_name": "IRENE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-22",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-15769",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "75364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perham, MN

Sources for this page

Verify at the official NPI Registry.