Individual provider Active NPI

Vicki G Nowak, M.D.

  • Otolaryngology Physician
  • Panama City, FL
National Provider Identifier
1689612145
Registry record updated Dec 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
ME92945 Issued in FL
Practice address
200 Doctors Dr
Panama City, FL 32405-4559
Phone
(850) 784-7722
Fax
(850) 784-6903
NPI assigned
Jun 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X ME92945 FL Primary

Addresses

Primary practice location

200 Doctors Dr
Panama City, FL 32405-4559

Mailing address

200 Doctors Dr
Panama City, FL 32405-4559
Phone (850) 784-7722

Other identifiers 3

IdentifierTypeStateIssuer
257724100MedicaidFL
272550900MedicaidFL
03528OtherBLUE CROSS

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20050812000170 FL Practitioner - Otolaryngology 8325077001 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Florida College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT and Allergy Associates of Florida, LLCGroup PAC ID 0042292849, 227 clinicians

Practice addresses (Care Compare)

200 Doctors Dr
Panama City, FL 32405-4559
Phone (850) 784-7722

900 NW 13TH St
Suite 206
Boca Raton, FL 33486-2350
Phone (561) 391-3333

Hospital & facility affiliations

  • HCA Florida Gulf Coast Hospital Hospital, Panama City, FL, CCN 100242

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
ENT and Allergy Associates of Florida, LLC Otolaryngology CurrentSince Sep 1, 2018 Accepting new patients

Locations

900 NW 13th St
Ste 206
Boca Raton, FL 33486
Phone (561) 338-3267

6421 Congress Ave
Ste 113
Boca Raton, FL 33487
Phone (561) 338-3267

1303 Mosley Dr
Lynn Haven, FL 32444
Phone (850) 271-5996

200 Doctors Dr
Panama City, FL 32405
Phone (850) 784-7722

Interoperability endpoints

  • Direct secure messaging: vnowak@entaaf.emadirect.md

Organizations & group practices 1

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 1

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": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734825600000",
    "number": "1689612145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 DOCTORS DR",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054559",
            "telephone_number": "850-784-7722",
            "fax_number": "850-784-6903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 DOCTORS DR",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054559",
            "telephone_number": "850-784-7722",
            "fax_number": "850-784-6903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWAK",
        "first_name": "VICKI",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-04",
        "last_updated": "2024-12-22",
        "certification_date": "2024-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME92945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "257724100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "272550900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "03528",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.