Individual provider Active NPI

Marni Lisa Novick, AU.D.

  • Audiologist
  • Los Gatos, CA
National Provider Identifier
1336176676
Registry record updated Nov 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AU2085 Issued in CA
Practice address
340 Dardanelli LN
Suite 22a
Los Gatos, CA 95032-1418
Phone
(408) 540-7128
Fax
(408) 599-3013
NPI assigned
Jun 26, 2006
Last updated
Nov 26, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AU2085 CA Primary

Addresses

Primary practice location

340 Dardanelli LN
Suite 22a
Los Gatos, CA 95032-1418

Mailing address

340 Dardanelli LN
Ste. 22a
Los Gatos, CA 95032-1418
Phone (408) 540-7128

Other identifiers 1

IdentifierTypeStateIssuer
CA119896OtherCAMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051004000303 CA Practitioner - Qualified Audiologist 4880588847 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Silicon Valley Hearing Clinic IncGroup PAC ID 7012130693, 2 clinicians

Practice addresses (Care Compare)

340 Dardanelli LN
Suite 22
Los Gatos, CA 95032-1418
Phone (408) 540-7128

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2085CAMDOccupational Therapist
AU2085CAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Silicon Valley Hearing Clinic, Inc. CurrentSince Jan 1, 2014 Accepting new patients
Pacific Hearing Clinic Past Accepting new patients
Pacific Hearing Clinic Inc. PastSince Aug 25, 2025 Accepting new patients
Carissa Bennett, Aud, Inc Audiologist Past Accepting new patients
Matt Michaels, M.S. Audiologist Past Accepting new patients
Pacific Hearing & Balance., Inc Past Accepting new patients

Locations

340 Dardanelli Ln
Ste 22
Los Gatos, CA 95032
Phone (408) 540-7128

Organizations & group practices 7

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511654400000",
    "number": "1336176676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 DARDANELLI LN",
            "address_2": "STE. 22A",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950321418",
            "telephone_number": "408-540-7128",
            "fax_number": "405-599-3013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 DARDANELLI LN",
            "address_2": "SUITE 22A",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950321418",
            "telephone_number": "408-540-7128",
            "fax_number": "408-599-3013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVICK",
        "first_name": "MARNI",
        "middle_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-26",
        "last_updated": "2017-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CA",
            "license": "AU2085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CA119896",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.