Individual provider Active NPI

Danilo Jose Novoa, LCSW

  • Clinical Social Worker
  • Houston, TX
National Provider Identifier
1497938393
Registry record updated Jul 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
38953 Issued in TX
Practice address
4617 Montrose Blvd
Suite C206
Houston, TX 77006-6101
Phone
(713) 992-5010
Fax
(888) 480-8948
NPI assigned
Dec 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 9717 TX
Clinical Social Worker 1041C0700X 38953 TX Primary

Addresses

Primary practice location

4617 Montrose Blvd
Suite C206
Houston, TX 77006-6101

Mailing address

415 E 27TH St
Houston, TX 77008-2203
Phone (713) 992-5010

Other identifiers 1

IdentifierTypeStateIssuer
TXB111128OtherTXTRAILBLAZER ENTERPRISES (MEDICARE/CMS)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101105000795 TX Practitioner - Clinical Social Worker 9739166562 Practice locations: Houston, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

415 E 27TH St
Houston, TX 77008-2203

428 Lovett Blvd
Houston, TX 77006-4019
Phone (713) 992-5010

4318 Stanford St
Houston, TX 77006-5930
Phone (713) 992-5010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38953TXMDPsychologist
991HIMDProsthodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Kevin G. Smith PHD and Associates PastSince Sep 10, 1993 Accepting new patients
Malik Naz, M.D., P.a 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": "1197504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342051200000",
    "number": "1497938393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 E 27TH ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770082203",
            "telephone_number": "713-992-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4617 MONTROSE BLVD",
            "address_2": "SUITE C206",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770066101",
            "telephone_number": "713-992-5010",
            "fax_number": "888-480-8948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVOA",
        "first_name": "DANILO",
        "middle_name": "JOSE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-13",
        "last_updated": "2012-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "9717",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "38953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAILBLAZER ENTERPRISES (MEDICARE/CMS)",
            "identifier": "TXB111128",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.