Mallory E Novack, D.O.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

20A13191 Issued in CA

Practice address

400 N Pepper Ave # 206
Colton, CA 92324-1801

Phone

(909) 580-2270

Fax

(909) 580-3289

NPI assigned

Mar 27, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MT, CA2 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

Specialty

Obstetrics/Gynecology

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kalispell Regional Medical Center IncGroup PAC ID 5294644381, 422 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Logan Health Medical Center Hospital, Kalispell, MT, CCN 270051

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: krmcmedicalrecords@krhdirect.org
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: mallory.novack.p2@direct.mpmccorp.nextgenshare.com

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.

• Kalispell Regional Medical Center Inc

  • General Acute Care Hospital
  • Kalispell, MT
  • NPI 1417945627
  Medicare reassignment Care Compare group
• Valley Obstetrics & Gynecology Medical Group, Inc.

  • Obstetrics & Gynecology Physician
  • Colton, CA
  • NPI 1144304817
  Medicare reassignment NPD
• Community Hospital of Anaconda

  • Critical Access Hospital
  • Anaconda, MT
  • NPI 1205887924
  Medicare reassignment NPD
• Kalispell Regional Medical Center Inc

  • Maternal & Fetal Medicine Physician
  • Kalispell, MT
  • NPI 1053798710
  NPD
• Kalispell Regional Medical Center Inc

  • Clinic/Center
  • Kalispell, MT
  • NPI 1235333139
  NPD
• Kalispell Regional Medical Center, Inc

  • Radiology Clinic/Center
  • Whitefish, MT
  • NPI 1073362463
  NPD
• Pacific Perinatal Institute

  • Maternal & Fetal Medicine Physician
  • Colton, CA
  • NPI 1942692777

  Obstetrics & Gynecology

  NPD (past)
• Billings Clinic

  • General Acute Care Hospital
  • Billings, MT
  • NPI 1265478291
  NPD (past)
• Kalispell Regional Medical Center, Inc

  • Surgery Physician
  • Kalispell, MT
  • NPI 1215527403
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kalispell Regional Medical Center Inc

  • Surgical Oncology Physician
  • Kalispell, MT
  • NPI 1053790063

  Hospital

  Care Compare affiliation
• Kalispell Regional Medical Center Inc

  • Maternal & Fetal Medicine Physician
  • Kalispell, MT
  • NPI 1053798710

  Hospital

  Care Compare affiliation
• Kalispell Regional Medical Center Inc

  • General Acute Care Hospital
  • Kalispell, MT
  • NPI 1417945627
  Care Compare affiliation
• Kalispell Regional Medical Center Inc

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Kalispell, MT
  • NPI 1477989770

  Hospital

  Care Compare affiliation
• Kalispell Regional Medical Center Inc

  • Nephrology Physician
  • Kalispell, MT
  • NPI 1700277837

  Hospital

  Care Compare affiliation
• Kalispell Regional Medical Center Inc

  • Hematology & Oncology Physician
  • Kalispell, MT
  • NPI 1891151122

  Hospital

  Care Compare affiliation
• Kalispell Regional Medical Center Inc

  • Obstetrics & Gynecology Physician
  • Kalispell, MT
  • NPI 1972982981

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1427324185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10273 NORTHRIDGE DR",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917373042",
            "telephone_number": "406-498-1090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE # 206",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801",
            "telephone_number": "909-580-2270",
            "fax_number": "909-580-3289"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 W Pennsylvania Ave",
            "address_purpose": "LOCATION",
            "city": "Anaconda",
            "state": "MT",
            "postal_code": "59711",
            "country_code": "US",
            "telephone_number": "559-499-6548",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "726 N Medical Center Dr E Ste 223",
            "address_purpose": "LOCATION",
            "city": "Clovis",
            "state": "CA",
            "postal_code": "936116886",
            "country_code": "US",
            "telephone_number": "559-472-4255",
            "fax_number": "559-324-8786",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2210 E Illinois Ave Ste 301",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937012184",
            "country_code": "US",
            "telephone_number": "559-320-0555",
            "fax_number": "559-320-0558",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "305 W Pennsylvania Ave",
            "address_purpose": "LOCATION",
            "city": "Anaconda",
            "state": "MT",
            "postal_code": "597111900",
            "country_code": "US",
            "telephone_number": "406-563-7282",
            "fax_number": "406-563-7243",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "210 Sunnyview Ln Ste 103",
            "address_purpose": "LOCATION",
            "city": "Kalispell",
            "state": "MT",
            "postal_code": "599013128",
            "country_code": "US",
            "telephone_number": "406-257-3872",
            "fax_number": "406-758-7077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOVACK",
        "first_name": "MALLORY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-27",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MT",
            "license": "49924",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "20A13191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1427324185",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427324185",
            "state": "MT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center Inc",
            "address_1": "210 Sunnyview Ln Ste 103",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Clara Nnadi, NURSE PRACTITIONER
• Tammy Nodler, CRNA
• Thet Myat Noe, MD
• Nomi Lee Dental Group Inc
• Patrik Norouzi, MD
• Alberto Nunez, MD
• Danitza Marie Nunez
• Steven Nunez
• Nnenna E Nwagbo
• Henrietta N Nwamu

• Obstetrics & Gynecology Physician in Colton, CA
• Providers in Colton, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.