Individual provider Active NPI

Marina Novack, CRNA

  • Anesthesiology Physician
  • Tucson, AZ
National Provider Identifier
1649742990
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
693851 Issued in NY
Practice address
5240 E Knight Dr Ste 104
Tucson, AZ 85712-2122
Phone
(540) 545-1021
NPI assigned
Dec 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 693851 NY Primary

Addresses

Primary practice location

5240 E Knight Dr Ste 104
Tucson, AZ 85712-2122

Mailing address

5240 E Knight Dr Ste 104
Tucson, AZ 85712-2122
Phone (540) 545-1021

Other practice location 1

1450 Western Ave Ste 102
Albany, NY 12203-3539
Phone (518) 463-0050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210514002398 AZ Practitioner - Certified Registered Nurse Anesthetist (Crna) 3577803907 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner-University Medical GroupGroup PAC ID 7719899871, 1,066 clinicians
Ias Arizona PLLCGroup PAC ID 7517312648, 122 clinicians

Practice addresses (Care Compare)

1625 N Campbell Ave
Tucson, AZ 85719-4330
Phone (520) 694-0111

5301 E Grant Rd
Tucson, AZ 85712-2805
Phone (469) 340-1366

Hospital & facility affiliations

  • Tucson Medical Center Hospital, Tucson, AZ, CCN 030006
  • Banner - University Medical Center Tucson Campus Hospital, Tucson, AZ, CCN 030064

Merit-based Incentive Payment System (MIPS)

Final score
93.34 of 100Reported as apm
Quality
74.56
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group CurrentSince Jul 1, 2021 Accepting new patients
Tucson Ambulatory Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 28, 2024 Accepting new patients
Ias Arizona PLLC Anesthesiology CurrentSince Dec 1, 2024 Accepting new patients
Banner-University Medical Group Anesthesiology Current Accepting new patients
Banner-University Medical Group CurrentSince Jul 1, 2021 Accepting new patients
Southern Arizona Anesthesia Services, PC Anesthesiology CurrentSince May 1, 2021 Accepting new patients

Locations

10360 E Drexel Rd
Tucson, AZ 85747
Phone (469) 340-1366

535 N Wilmot Rd
Ste 101
Tucson, AZ 85711
Phone (520) 694-9988

5240 E Knight Dr
Ste 104
Tucson, AZ 85712
Phone (520) 795-4202

5301 E Grant Rd
Tucson, AZ 85712
Phone (520) 324-1344

3390 N Campbell Ave
Ste 110
Tucson, AZ 85719
Phone (520) 784-2243

350 N Wilmot Rd
Tucson, AZ 85711
Phone (520) 873-3000

1625 N Campbell Ave
Tucson, AZ 85719

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

2424 N Wyatt Dr
Ste 160
Tucson, AZ 85712
Phone (520) 784-6500

Organizations & group practices 6

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 3

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": "1545868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1649742990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5240 E KNIGHT DR STE 104",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122122",
            "telephone_number": "540-545-1021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5240 E KNIGHT DR STE 104",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122122",
            "telephone_number": "540-545-1021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1450 Western Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122033539",
            "country_code": "US",
            "telephone_number": "518-463-0050",
            "fax_number": "518-207-2973",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOVACK",
        "first_name": "MARINA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-27",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "693851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.