Active NPI
Gordon M Novak, MD
- Anesthesiology Physician
- Brighton, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 154452
- Practice address
- 736 Cambridge St
Brighton, MA 02135-2907 - Phone
- (617) 789-2777
- Fax
- (617) 254-6384
- NPI assigned
- Oct 17, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | 154452 | MA | |
| Anesthesiology Physician | 207L00000X | 154452 | MA | Primary |
Addresses
Primary practice location
736 Cambridge St
Brighton, MA 02135-2907
Mailing address
690 Canton St
Suite 325
Westwood, MA 02090-2321
Phone (781) 407-7713
Other practice location 1
119 Belmont St
Worcester, MA 01605-2903
Phone (508) 793-6802
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3180981 | Medicaid | MA |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mnovak48125@UmassMemorial.direct-ci.com | ||
| FHIR URL | https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Medical College of Wisconsin, 1993
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
440 Swansea Mall Dr
Swansea, MA 02777-4114
Phone (508) 324-1171
Hospital & facility affiliations
- Saint Anne'S Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 82.98
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 154452 | MA | MD | Pain Medicine (Anesthesiology) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifespan Physician Group of Massachusetts Inc | Anesthesiology | Current | Accepting new patients |
| Caritas Medical Group, Inc. | Past | Accepting new patients |
Locations
795 Middle St
Fall River, MA 02721
Phone (508) 235-5046
531 Faunce Corner Rd
North Dartmouth, MA 02747
Phone (508) 991-2255
440 Swansea Mall Dr
Swansea, MA 02777
Phone (508) 324-1171
Interoperability endpoints
- mnovak48125@umassmemorial.direct-ci.com
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.
-
- Family Medicine Physician
- Taunton, MA
- NPI 1235957713
Anesthesiology
-
- Specialist
- Brighton, MA
- NPI 1174513204
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fall River, MA
- NPI 1972330165
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606262400000",
"number": "1629067319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "690 CANTON ST",
"address_2": "SUITE 325",
"city": "WESTWOOD",
"state": "MA",
"postal_code": "020902321",
"telephone_number": "781-407-7713",
"fax_number": "781-407-0998"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "736 CAMBRIDGE ST",
"city": "BRIGHTON",
"state": "MA",
"postal_code": "021352907",
"telephone_number": "617-789-2777",
"fax_number": "617-254-6384"
}
],
"practiceLocations": [
{
"address_1": "119 Belmont St",
"address_purpose": "LOCATION",
"city": "Worcester",
"state": "MA",
"postal_code": "016052903",
"country_code": "US",
"telephone_number": "508-793-6802",
"fax_number": "508-793-6819",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NOVAK",
"first_name": "GORDON",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-17",
"last_updated": "2020-11-25",
"certification_date": "2020-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "MA",
"license": "154452",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MA",
"license": "154452",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3180981",
"state": "MA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mnovak48125@UmassMemorial.direct-ci.com",
"affiliation": "N",
"address_1": "119 Belmont St",
"city": "Worcester",
"state": "MA",
"country_code": "US",
"postal_code": "016052903",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "119 Belmont St",
"city": "Worcester",
"state": "MA",
"country_code": "US",
"postal_code": "016052903",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Brighton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; 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.