Blaine B Nowak, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

22481 Issued in WI

Practice address

3524 E Milwaukee St
Janesville, WI 53546-1626

Phone

(608) 756-7100

NPI assigned

Dec 8, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Mercy Health System Corporation

  • Multi-Specialty Clinic/Center
  • Janesville, WI
  • NPI 1598718603
  Medicare reassignment NPD
• Mercy Health System Corporation

  • General Acute Care Hospital
  • Janesville, WI
  • NPI 1093768962
  NPD
• Mercy Health System Corporation

  • Critical Access Hospital
  • Lake Geneva, WI
  • NPI 1699728550
  NPD

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669531141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3524 E MILWAUKEE ST",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535461626",
            "telephone_number": "608-756-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3524 E MILWAUKEE ST",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535461626",
            "telephone_number": "608-756-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWAK",
        "first_name": "BLAINE",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "22481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30391700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nolte Chiropractic LLC
• Jeffery Dean Nolte, D.C.
• Margo Beth Nolte, D.C.
• Alison Norwood
• Robert Nottestad, SAC-IT
• Jennifer Michelle Nowak, LCSW
• Daniel Nunez
• Nichole Nunn
• Nutrition and Health Associates,Inc.
• Lauren Marie O'Brien, DMD

• Pediatrics Physician in Janesville, WI
• Providers in Janesville, WI by specialty
• Pediatrics Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.