Mary E Novotny

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

209-013360 Issued in IL

Practice address

3535 N Bell School Rd
Rockford, IL 61114-6624

Phone

(779) 696-9400

Fax

(779) 696-9334

NPI assigned

Jun 19, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mary Johnson Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Swedishamerican HospitalGroup PAC ID 5799698346, 386 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uw Health Hospital, Rockford, IL, CCN 140228

Merit-based Incentive Payment System (MIPS)

Final score

91.05 of 100Reported as apm

Quality

72.1

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

81.51 of 100Reported as group

Quality

83.2

Promoting interoperability

77

Improvement activities

40

Cost

71.7

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mjohnson911867@direct.uwhealth.org

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.

• Swedishamerican Hospital

  • Family Medicine Physician
  • Rockford, IL
  • NPI 1962451732
  Medicare reassignment Care Compare group NPD
• Swedishamerican Hospital

  • Family Medicine Physician
  • Rockford, IL
  • NPI 1225126873
  NPD
• Swedishamerican Hospital

  • Community/Retail Pharmacy
  • Rockford, IL
  • NPI 1306635982
  NPD

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

• Swedishamerican Hospital

  • General Acute Care Hospital
  • Rockford, IL
  • NPI 1760542732
  Care Compare affiliation

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

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1689056285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 78866",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532788866",
            "telephone_number": "779-696-7150",
            "fax_number": "779-696-7342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 N BELL SCHOOL RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611146624",
            "telephone_number": "779-696-9400",
            "fax_number": "779-696-9334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1340 Charles St",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "61104",
            "country_code": "US",
            "telephone_number": "779-696-8700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOVOTNY",
        "first_name": "MARY",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-19",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "209-013360",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041-359227",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mjohnson911867@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "1340 Charles St",
            "address_2": "Suite 100",
            "city": "Rockford",
            "state": "IL",
            "country_code": "US",
            "postal_code": "61104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "JOHNSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kathryn N Norup, PTA
• Mary Ann Norwood, MA
• Sage M Norwood, PA-C
• Lance K. Novak
• Maya Novik
• Gregory G Nowak, MD
• Magdalena Nowak, MD
• Chijindu Nnaemeka Nwakama, MD
• Catherine Nwosu
• Rebecca J Nygren, P.T., D.P.T.

• Gerontology Nurse Practitioner in Rockford, IL
• Providers in Rockford, IL by specialty
• Gerontology Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; 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.