Ned R. Novsam, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

0030072 Issued in WI

Practice address

6308 8TH Ave
Suite 503
Kenosha, WI 53143-5031

Phone

(262) 656-8213

Fax

(262) 656-8233

NPI assigned

Jul 5, 2006

Last updated

Dec 11, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Kenosha Urology Clinic, S.C.

  • Urology Physician
  • Kenosha, WI
  • NPI 1396831343
  Authorized official Same address or phone

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260489600000",
    "number": "1760413900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6308 8TH AVE",
            "address_2": "SUITE 503",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531435031",
            "telephone_number": "262-656-8213",
            "fax_number": "262-656-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6308 8TH AVE",
            "address_2": "SUITE 503",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531435031",
            "telephone_number": "262-656-8213",
            "fax_number": "262-656-8233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVSAM",
        "first_name": "NED",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2009-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WI",
            "license": "0030072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31494300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NJM Management Services, Inc.
• Noble Journey LLC
• Gerald Joseph Nora, M.D.
• Nova Dental LLC
• Jerome Novak, PT
• Lacy Nowicki, OTR/L
• Beth Nowikowski, PTA
• NSH Kenosha LLC
• Matthew A Nuciforo, PT, DPT, OCS
• Anne Nudi, DNP, APRN, FNP-BC

• Urology Physician in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Urology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.