Individual provider Active NPI

Joanne Nowak, MD

  • Internal Medicine Physician
  • Lawrence, MA
National Provider Identifier
1184615007
Registry record updated Mar 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
54126 Issued in MA
Practice address
360 Merrimack St Ste 9
Lawrence, MA 01843-1764
Phone
(978) 552-4080
NPI assigned
Oct 31, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2015

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 54126 MA Primary

Addresses

Primary practice location

360 Merrimack St Ste 9
Lawrence, MA 01843-1764

Mailing address

360 Merrimack St Ste 9
Lawrence, MA 01843-1764
Phone (978) 552-4080

Other identifiers 3

IdentifierTypeStateIssuer
3064441MedicaidMA
715023OtherMATUFTS HEALTH PLAN
J04598OtherMABCBS MA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, DE2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050502001040 MA Practitioner - Internal Medicine 5890734560 Reassigns benefits to 1 organization
I20250908002483 DE Practitioner - Internal MedicinePractitioner - Family Practice 5890734560 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Family Practice
Education
Boston University School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

101 N Main St
Unit 500
Providence, RI 02903-1365

78 Pine St
Andover, MA 01810-1714

Hospital & facility affiliations

  • Tufts Medicine Care at Home Hospice, Lowell, MA, CCN 221508

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54126MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tufts Medicine Care at Home, Inc. CurrentSince Aug 23, 2010 Accepting new patients
Tufts Medicine Care at Home, Inc. CurrentSince Aug 23, 2010 Accepting new patients

Locations

847 Rogers St
Ste 201
Lowell, MA 01852
Phone (978) 459-9343

Interoperability endpoints

  • Direct secure messaging: jnowak31389@tuftsmedicine.direct-ci.com

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 2

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": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425340800000",
    "number": "1184615007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 MERRIMACK ST STE 9",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018431764",
            "telephone_number": "978-552-4080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 MERRIMACK ST STE 9",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018431764",
            "telephone_number": "978-552-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWAK",
        "first_name": "JOANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-31",
        "last_updated": "2015-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "54126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3064441",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "715023",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "J04598",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, MA

Sources for this page

Verify at the official NPI Registry.