Individual provider Active NPI

Robert P Novicki, DPM

  • Podiatrist
  • Milford, CT
National Provider Identifier
1316975592
Registry record updated Feb 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
000408 Issued in CT
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

Updated by the provider on Feb 6, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0706090003OtherCTMEDICARE 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

LicenseStateTypeSpecialty
408CTMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.