Active NPI
Robert P Novicki, DPM
- Podiatrist
- Milford, CT
National Provider Identifier
1316975592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 000408
- Practice address
- 32 Cherry St
Milford, CT 06460-3413 - Phone
- (203) 874-6755
- NPI assigned
- Jun 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 000408 | CT | Primary |
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 000408 | CT |
Addresses
Primary practice location
32 Cherry St
Milford, CT 06460-3413
Mailing address
32 Cherry St
Milford, CT 06460-3413
Phone (203) 874-6755
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0706090003 | Other | CT | MEDICARE DMERC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 408 | CT | MD | Advanced Practice Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Raphael Healthcare System Affiliated Physicians Inc | Past | Accepting new patients | |
| Saint Raphael Faculty Physicians | Past | Accepting new patients |
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 and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202256000000",
"number": "1316975592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32 CHERRY ST",
"city": "MILFORD",
"state": "CT",
"postal_code": "064603413",
"telephone_number": "203-874-6755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "32 CHERRY ST",
"city": "MILFORD",
"state": "CT",
"postal_code": "064603413",
"telephone_number": "203-874-6755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOVICKI",
"first_name": "ROBERT",
"middle_name": "P",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-28",
"last_updated": "2008-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "CT",
"license": "000408",
"primary": true
},
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "CT",
"license": "000408",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE DMERC",
"identifier": "0706090003",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Milford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.