Individual provider Active NPI

Rachel D Novak, NP

  • Nurse Practitioner
  • Salem, WI
National Provider Identifier
1699550053
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
14058 Issued in WI
Practice address
25320 75TH St
Salem, WI 53168-9684
Phone
(262) 843-2336
NPI assigned
Aug 25, 2023
Last updated
Aug 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 14058 WI Primary

Addresses

Primary practice location

25320 75TH St
Salem, WI 53168-9684

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (262) 843-2336

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rnovak222103@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231027002364 WI Practitioner - Nurse Practitioner 6406202332 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Independent Physicians of Wisconsin LLCGroup PAC ID 3274842034, 42 clinicians

Practice addresses (Care Compare)

6125 Green Bay Rd
Suite 600
Kenosha, WI 53142-2928
Phone (877) 287-1962

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
14058WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Physicians of Wisconsin, LLC CurrentSince Apr 1, 2025 Accepting new patients
Independent Physicians of Wisconsin, LLC CurrentSince Apr 1, 2025 Accepting new patients

Locations

6125 Green Bay Rd
Ste 600
Kenosha, WI 53142
Phone (414) 229-9637

5434 W Capitol Dr
Ste 3
Milwaukee, WI 53216
Phone (414) 217-1229

Interoperability endpoints

  • Direct secure messaging: rachel.novak.1@18758.direct.athenahealth.com
  • Direct secure messaging: rnovak222103@direct.myadvocateaurora.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1692921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1699550053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "262-843-2336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25320 75TH ST",
            "city": "SALEM",
            "state": "WI",
            "postal_code": "531689684",
            "telephone_number": "262-843-2336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVAK",
        "first_name": "RACHEL",
        "middle_name": "D",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-25",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "14058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rnovak222103@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "25320 75th St",
            "city": "Salem",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531689684",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "25320 75th St",
            "city": "Salem",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531689684",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salem, WI

Sources for this page

Verify at the official NPI Registry.