Organization Active NPI

Novak & Novak PA

  • Specialist
  • Destin, FL
National Provider Identifier
1730384348
Registry record updated Mar 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME47513 Issued in FL
Legal business name
NOVAK & NOVAK PA
Practice address
994 Airport Rd
Destin, FL 32541-2820
Phone
(850) 837-7777
Fax
(850) 837-8801
NPI assigned
Jun 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2012

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

Authorized official

Name
Yvette Novak, M.D.NPI 1780677559
Title
Physician
Phone
(850) 837-0141

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X ME47513 FL Primary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X ME47875 FL

Addresses

Primary practice location

994 Airport Rd
Destin, FL 32541-2820

Mailing address

PO Box 907
Destin, FL 32540-0907
Phone (850) 837-7777

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120326000591 FL Part B Supplier - Clinic/Group Practice 5799945986 Receives reassigned benefits from 1 practitioner
Practice locations: Destin, FL

National Provider Directory

National Provider Directory

Locations

994 Airport Rd
Destin, FL 32541
Phone (850) 837-0141

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332201600000",
    "number": "1730384348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 907",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325400907",
            "telephone_number": "850-837-7777",
            "fax_number": "850-837-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "994 AIRPORT RD",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325412820",
            "telephone_number": "850-837-7777",
            "fax_number": "850-837-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVAK & NOVAK PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-15",
        "last_updated": "2012-03-20",
        "status": "A",
        "authorized_official_last_name": "NOVAK",
        "authorized_official_first_name": "YVETTE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "850-837-0141",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME47513",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME47875",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Destin, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.