Individual provider Active NPI

Gregory Scott Nowak, MD

  • Anesthesiology Physician
  • Elkhart, IN
National Provider Identifier
1184608390
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01033943A Issued in IN
Practice address
3080 Windsor CT
Suite B
Elkhart, IN 46514-5555
Phone
(574) 266-7817
Fax
(574) 266-7943
NPI assigned
Dec 1, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 01033943A IN Primary

Addresses

Primary practice location

3080 Windsor CT
Suite B
Elkhart, IN 46514-5555

Mailing address

541 Otis Bower Dr
Munster, IN 46321
Phone (219) 934-5300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051213000752 IN Practitioner - Anesthesiology 4688587405 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01033943AINMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Anesthesia, P.C. Anesthesiology CurrentSince Apr 30, 2003 Accepting new patients
Great Lakes Anesthesia, P.C. Anesthesiology Past Accepting new patients

Locations

3080 Windsor Ct
#B
Elkhart, IN 46514
Phone (574) 266-7817

500 Arcade Ave
Ste 100
Elkhart, IN 46514
Phone (574) 389-5683

1500 S Lake Park Ave
Hobart, IN 46342
Phone (219) 942-0551

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1184608390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 OTIS BOWER DR",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "46321",
            "telephone_number": "219-934-5300",
            "fax_number": "219-934-5389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3080 WINDSOR CT",
            "address_2": "SUITE B",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465145555",
            "telephone_number": "574-266-7817",
            "fax_number": "574-266-7943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWAK",
        "first_name": "GREGORY",
        "middle_name": "SCOTT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01033943A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

Verify at the official NPI Registry.