Active NPI
Matthew Novack, MD
- Family Medicine Physician
- Port Angeles, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD61105776
- Practice address
- 240 W Front St
Port Angeles, WA 98362-2609 - Phone
- (360) 452-7891
- Fax
- (360) 452-8087
- NPI assigned
- Mar 20, 2018
- 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 |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | MD61105776 | WA | |
| Family Medicine Physician | 207Q00000X | MD61105776 | WA | Primary |
Addresses
Primary practice location
240 W Front St
Port Angeles, WA 98362-2609
Mailing address
240 W Front St
Port Angeles, WA 98362-2609
Phone (360) 452-7891
Other practice location 1
3900 Capital Mall Dr SW
Olympia, WA 98502-5026
Phone (360) 706-6537
Other practice location 2
530 Bogachiel Way
Forks, WA 98331-9120
Phone (360) 374-6271
Other practice location 3
939 Caroline St
Port Angeles, WA 98362-3997
Phone (360) 417-7000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2104109 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- 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
- Family Practice
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
240 W Front St
Suite a
Port Angeles, WA 98362-2609
Phone (360) 452-7891
939 Caroline St
Port Angeles, WA 98362-3909
Phone (360) 417-7000
Hospital & facility affiliations
- Olympic Medical Home Health
- Olympic Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Olympic Medical Physicians | Family Medicine | Current | Accepting new patients |
| South Sound Inpatient Physicians PLLC | Family Medicine | Current | Accepting new patients |
| North Olympic Healthcare Network | Current | Accepting new patients | |
| North Olympic Healthcare Network | Current | Accepting new patients | |
| Capital Medical Center Specialty Physicians, LLC | Hospitalist | Current | Accepting new patients |
| South Sound Inpatient Physicians PLLC | Family Medicine | Current | Accepting new patients |
| South Sound Inpatient Physicians PLLC | Family Medicine | Current | Accepting new patients |
| Cogent Healthcare of Washington, PC | Family Medicine | Current | Accepting new patients |
| North Olympic Healthcare Network | Current | Accepting new patients | |
| Multicare Health System | Current | Accepting new patients | |
| Multicare Health System | Current | Accepting new patients | |
| Multicare Health System | Family Medicine | Current | Accepting new patients |
| Clallam County Public Hospital District 2 | Past | Accepting new patients |
Locations
202 N Division St
Auburn, WA 98001
Phone (253) 333-2562
16251 Sylvester Rd SW
Burien, WA 98166
Phone (206) 244-9970
4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590
222 State Ave N
Kent, WA 98030
Phone (253) 372-7680
3900 Capital Mall Dr SW
Olympia, WA 98502
Phone (360) 704-4743
933 E 1st St
Port Angeles, WA 98362
Phone (360) 452-4432
433 E 8th St
Port Angeles, WA 98362
Phone (360) 452-3373
939 Caroline St
Port Angeles, WA 98362
Phone (360) 417-7315
1026 E 1st St
Port Angeles, WA 98362
Phone (360) 452-4432
240 W Front St
Port Angeles, WA 98362
Phone (360) 452-7891
240 W Front St
Ste A
Port Angeles, WA 98362
Phone (360) 452-7891
407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000
2000 Hospital Dr
Sedro Woolley, WA 98284
Phone (360) 856-6021
521 S K St
Tacoma, WA 98405
Phone (253) 403-2900
Interoperability endpoints
- mnovack2656158@wm.providencedirect.org
Organizations & group practices 13
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.
-
- Federally Qualified Health Center (FQHC)
- Port Angeles, WA
- NPI 1154702264
-
- Family Medicine Physician
- Port Angeles, WA
- NPI 1427081967
-
- Occupational Medicine Physician
- Olympia, WA
- NPI 1760785281
Hospitalist
-
- Neurological Surgery Physician
- Tacoma, WA
- NPI 1497766638
-
- Internal Medicine Physician
- Vancouver, WA
- NPI 1023285756
Family Medicine
-
- Internal Medicine Physician
- Vancouver, WA
- NPI 1861430522
Family Medicine
-
- Family Medicine Physician
- Tacoma, WA
- NPI 1326093873
-
- Community/Retail Pharmacy
- Spokane, WA
- NPI 1396594875
-
- Federally Qualified Health Center (FQHC)
- Port Angeles, WA
- NPI 1568961969
-
- Federally Qualified Health Center (FQHC)
- Port Angeles, WA
- NPI 1639036924
-
- Internal Medicine Physician
- Bremerton, WA
- NPI 1831366566
Family Medicine
-
- Internal Medicine Physician
- Hillsboro, OR
- NPI 1508023789
Family Medicine
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Port Angeles, WA
- NPI 1306845557
-
- Home Health Agency
- Port Angeles, WA
- NPI 1437259165
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783987200000",
"number": "1659875136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 W FRONT ST",
"city": "PORT ANGELES",
"state": "WA",
"postal_code": "983622609",
"telephone_number": "360-452-7891",
"fax_number": "360-452-8087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 W FRONT ST",
"city": "PORT ANGELES",
"state": "WA",
"postal_code": "983622609",
"telephone_number": "360-452-7891",
"fax_number": "360-452-8087"
}
],
"practiceLocations": [
{
"address_1": "3900 Capital Mall Dr SW",
"address_purpose": "LOCATION",
"city": "Olympia",
"state": "WA",
"postal_code": "985025026",
"country_code": "US",
"telephone_number": "360-706-6537",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "530 Bogachiel Way",
"address_purpose": "LOCATION",
"city": "Forks",
"state": "WA",
"postal_code": "983319120",
"country_code": "US",
"telephone_number": "360-374-6271",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "939 Caroline St",
"address_purpose": "LOCATION",
"city": "Port Angeles",
"state": "WA",
"postal_code": "983623997",
"country_code": "US",
"telephone_number": "360-417-7000",
"fax_number": "360-417-7318",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NOVACK",
"first_name": "MATTHEW",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-03-20",
"last_updated": "2026-07-14",
"certification_date": "2026-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "WA",
"license": "MD61105776",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD61105776",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2104109",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Port Angeles, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; 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.