Individual provider Active NPI

Nicholas James Novak, DO

  • Otolaryngology Physician
  • Lackland AFB, TX
National Provider Identifier
1740843986
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
05-51224 Issued in KS
Practice address
1100 Wilford Hall Loop
Lackland AFB, TX 78236-5638
Phone
(210) 292-5420
NPI assigned
Apr 14, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 05-51224 KS Primary
Otolaryngology Physician 207Y00000X 2025018162 MO

Addresses

Primary practice location

1100 Wilford Hall Loop
Lackland AFB, TX 78236-5638

Mailing address

1100 Wilford Hall Loop
Lackland AFB, TX 78236-5638

Other practice location 1

3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Phone (210) 916-2985

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250711001202 KS Practitioner - Otolaryngology 9830604719 Reassigns benefits to 1 organization
I20250723003837 MO Practitioner - Plastic and Reconstructive Surgery 9830604719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kansas University Physicians IncGroup PAC ID 8921911587, 1,809 clinicians

Practice addresses (Care Compare)

2301 Holmes St
Kansas City, MO 64108-2640
Phone (816) 404-1000

7405 Renner Rd
Shawnee, KS 66217-9414
Phone (913) 588-7070

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
05-51224KSMDOtolaryngology Physician
0102207138VAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Truman Medical Center, Incorporated CurrentSince Jul 11, 2025 Accepting new patients
Kansas University Physicians Inc Otolaryngology CurrentSince Jul 1, 2025 Accepting new patients
Kansas University Physicians Inc Otolaryngology Current Accepting new patients
Truman Medical Center, Incorporated Otolaryngology CurrentSince Jul 11, 2025 Accepting new patients
Kansas University Physicians Inc CurrentSince Jul 1, 2025 Accepting new patients
Truman Medical Center, Incorporated Current Accepting new patients
Truman Medical Centers, Inc. Past Accepting new patients
University Health Physicians Past Accepting new patients

Locations

4000 Cambridge St
Kansas City, KS 66160
Phone (913) 588-0000

3901 Rainbow Blvd
Kansas City, KS 66160
Phone (913) 588-6005

11300 Corporate Ave
Lenexa, KS 66219
Phone (913) 574-0600

7405 Renner Rd
Shawnee Msn, KS 66217
Phone (913) 588-2200

2301 Holmes St
Kansas City, MO 64108

2301 Holmes St
Fl 3
Kansas City, MO 64108

7900 Lees Summit Rd
Kansas City, MO 64139
Phone (816) 373-4485

Interoperability endpoints

  • Direct secure messaging: nnovak778859@direct.kuha.org
  • Direct secure messaging: nnovak39353@direct.utmsa.com

Organizations & group practices 8

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 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": "1555200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1740843986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP",
            "city": "LACKLAND AFB",
            "state": "TX",
            "postal_code": "782365638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP",
            "city": "LACKLAND AFB",
            "state": "TX",
            "postal_code": "782365638",
            "telephone_number": "210-292-5420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3551 Roger Brooke Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Sam Houston",
            "state": "TX",
            "postal_code": "782344504",
            "country_code": "US",
            "telephone_number": "210-916-2985",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOVAK",
        "first_name": "NICHOLAS",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-14",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "KS",
            "license": "05-51224",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MO",
            "license": "2025018162",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lackland AFB, TX

Sources for this page

Verify at the official NPI Registry.