Individual provider Active NPI

Steven J Novak, CRNA

  • Certified Registered Nurse Anesthetist
  • Minneapolis, MN
National Provider Identifier
1477528156
Registry record updated May 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R- 164393-2 Issued in MN
Practice address
2450 Riverside Ave
Minneapolis, MN 55454-1512
Phone
(612) 672-6000
NPI assigned
Feb 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R- 164393-2 MN Primary

Addresses

Primary practice location

2450 Riverside Ave
Minneapolis, MN 55454-1512

Mailing address

2450 Riverside Ave
Minneapolis, MN 55454-1450

Other identifiers 1

IdentifierTypeStateIssuer
176698800MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, SC, FL3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20120222001044 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 4486618501
I20170919001720 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 4486618501 Reassigns benefits to 1 organization
I20190913000346 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4486618501 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1800 SE Tiffany Ave
Port Saint Lucie, FL 34952-7521
Phone (954) 939-5000

7201 N University Dr
Tamarac, FL 33321-2913
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
R- 164393-2MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Physician Solutions of South Florida, LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2019 Accepting new patients
Low Country Anesthesia, PA CurrentSince Jul 1, 2017 Accepting new patients
Anesthesia Physician Solutions of South Florida, LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2019 Accepting new patients
Anesthesia Physician Solutions of South Florida, LLC Nurse Anesthetist, Certified Registered Current Accepting new patients

Locations

5301 S Congress Ave
Lantana, FL 33462
Phone (561) 548-3549

1800 SE Tiffany Ave
Port St Lucie, FL 34952
Phone (772) 398-1969

7201 N University Dr
Tamarac, FL 33321
Phone (954) 721-2200

955 Ribaut Rd
Beaufort, SC 29902
Phone (803) 522-5200

Organizations & group practices 4

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 1

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": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210809600000",
    "number": "1477528156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 RIVERSIDE AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 RIVERSIDE AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541512",
            "telephone_number": "612-672-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVAK",
        "first_name": "STEVEN",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2008-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R- 164393-2",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176698800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; 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.