Individual provider Active NPI

Jason Lyle Novick, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Capitola, CA
National Provider Identifier
1689630808
Registry record updated Oct 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E4661 Issued in CA
Practice address
525 Capitola Ave
Unit B
Capitola, CA 95010-2759
Phone
(831) 462-2132
Fax
(831) 462-2930
NPI assigned
Apr 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E4661 CA Primary

Addresses

Primary practice location

525 Capitola Ave
Unit B
Capitola, CA 95010-2759

Mailing address

525 Capitola Ave
Unit B
Capitola, CA 95010-2759
Phone (831) 462-2132

Other identifiers 1

IdentifierTypeStateIssuer
P00363267OtherCARAIL ROAD MEDICARE GROUP MEMBER PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060630000220 CA Practitioner - Podiatry 1759393069 Practice locations: Santa Cruz, CA

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1595 Soquel Dr
Suite 150
Santa Cruz, CA 95065-1717
Phone (831) 462-2132

Merit-based Incentive Payment System (MIPS)

Final score
78.27 of 100Reported as individual
Quality
51.34
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue39
Removal of skin lesions1-10
Removal of nail tissue2089
Removal or shaving of skin growth1705

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Past Accepting new patients
Foot Clinic of Santa Cruz County, Inc Foot & Ankle Surgery Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349308800000",
    "number": "1689630808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 CAPITOLA AVE",
            "address_2": "UNIT B",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "950102759",
            "telephone_number": "831-462-2132",
            "fax_number": "831-462-2930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 CAPITOLA AVE",
            "address_2": "UNIT B",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "950102759",
            "telephone_number": "831-462-2132",
            "fax_number": "831-462-2930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVICK",
        "first_name": "JASON",
        "middle_name": "LYLE",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2012-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE GROUP MEMBER PTAN",
            "identifier": "P00363267",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Capitola, CA

Sources for this page

Verify at the official NPI Registry.