Jacob Alexander Martin Novack, DO

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

5101028607 Issued in MI

Practice address

1037 Water St Ste 1
Port Huron, MI 48060-4408

Phone

(248) 967-7000

NPI assigned

Jun 1, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Urology

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

McLaren Medical GroupGroup PAC ID 3971416082, 240 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• McLaren Port Huron Hospital, Port Huron, MI, CCN 230216
• Lake Huron Medical Center Hospital, Port Huron, MI, CCN 230031
• McKenzie Health System Hospital, Sandusky, MI, CCN 231314

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• McLaren Medical Group

  • Family Medicine Physician
  • Lapeer, MI
  • NPI 1346396066
  Medicare reassignment Care Compare group NPD
• McLaren Medical Group

  • Diagnostic Radiology Physician
  • Lapeer, MI
  • NPI 1073650750
  NPD
• McLaren Medical Group

  • Internal Medicine Physician
  • Flint, MI
  • NPI 1780652206
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• McKenzie Memorial Hospital

  • Critical Access Hospital
  • Sandusky, MI
  • NPI 1497750608
  Care Compare affiliation
• McKenzie Memorial Hospital

  • Family Medicine Physician
  • Sandusky, MI
  • NPI 1831443761

  Hospital

  Care Compare affiliation
• McLaren Port Huron

  • General Acute Care Hospital
  • Port Huron, MI
  • NPI 1982685384
  Care Compare affiliation
• Prime Healthcare Services-Port Huron LLC

  • General Acute Care Hospital
  • Port Huron, MI
  • NPI 1306227764
  Care Compare affiliation

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

{
    "created_epoch": "1590969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1669096111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22644 RIDGEWAY ST",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801476",
            "telephone_number": "586-216-2615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1037 WATER ST STE 1",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480604408",
            "telephone_number": "248-967-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVACK",
        "first_name": "JACOB",
        "middle_name": "ALEXANDER MARTIN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-01",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "5101028607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Noland, LMSW
• Norbert P Czajkowski, MD, PC
• Norbert P Czajkowski, MD, PC
• Northpointe OB-GYN PC
• Noreen Louise Nortier, PA-C
• Brandon Novak, OTR/L
• Krystal Alice Nowak, LMSW
• Tochukwu Nwosa, MD
• Deborah Beth O'Brien
• Sara O'Donnell

• Urology Physician in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Urology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2025; 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.

Verify at the official NPI Registry.