Organization Active NPI

Nova Family Podiatry P.C.

  • Podiatrist
  • Eagleville, PA
National Provider Identifier
1477567790
Registry record updated Nov 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
SC004124L Issued in PA
Legal business name
NOVA FAMILY PODIATRY P.C.
Practice address
3125 Ridge Pike
Suite B
Eagleville, PA 19403-1407
Phone
(610) 631-3338
Fax
(610) 631-0313
NPI assigned
Jul 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2011

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

Authorized official

Name
Dr. Bernard A. Novabilski, D.P.M.NPI 1811903958
Title
Podiatrist
Phone
(610) 631-3338

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X SC004124L PA Primary

Addresses

Primary practice location

3125 Ridge Pike
Suite B
Eagleville, PA 19403-1407

Mailing address

3125 Ridge Pike
Suite B
Eagleville, PA 19403-1407
Phone (610) 631-3338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050427000164 PA Part B Supplier - Clinic/Group Practice 5496794729 Receives reassigned benefits from 1 practitioner
Practice locations: Eagleville, PA
O20100930046977 PA DME Supplier - Physician - Podiatry 5496794729 Practice locations: Eagleville, PA

National Provider Directory

National Provider Directory

Locations

3125 Ridge Pike
Ste B
Norristown, PA 19403
Phone (610) 409-2786

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320278400000",
    "number": "1477567790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 RIDGE PIKE",
            "address_2": "SUITE B",
            "city": "EAGLEVILLE",
            "state": "PA",
            "postal_code": "194031407",
            "telephone_number": "610-631-3338",
            "fax_number": "610-631-0313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 RIDGE PIKE",
            "address_2": "SUITE B",
            "city": "EAGLEVILLE",
            "state": "PA",
            "postal_code": "194031407",
            "telephone_number": "610-631-3338",
            "fax_number": "610-631-0313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA FAMILY PODIATRY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-29",
        "last_updated": "2011-11-03",
        "status": "A",
        "authorized_official_last_name": "NOVABILSKI",
        "authorized_official_first_name": "BERNARD",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "610-631-3338",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC004124L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagleville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.