Individual provider Active NPI

Holly Grace Novack

  • Anesthesiology Physician
  • Anchorage, AK
National Provider Identifier
1841533924
Registry record updated Dec 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ML125067 Issued in AK
Practice address
6620 Lawlor Cir
Anchorage, AK 99502-1961
Phone
(206) 225-4013
NPI assigned
Mar 27, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ML125067 AK Primary

Addresses

Primary practice location

6620 Lawlor Cir
Anchorage, AK 99502-1961

Mailing address

6620 Lawlor Cir
Anchorage, AK 99502-1961
Phone (206) 225-4013

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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 1

Enrollment IDStateProvider typePAC IDDetails
I20171228002266 AK Practitioner - Anesthesiology 5597054239 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Wayne State University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Denali Anesthesia LLCGroup PAC ID 2567455678, 25 clinicians

Practice addresses (Care Compare)

2801 Debarr Rd
Anchorage, AK 99508-2932
Phone (907) 276-1257

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ML125067AKMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Denali Anesthesia, LLC Anesthesiology CurrentSince Nov 1, 2017 Accepting new patients

Locations

2801 Debarr Rd
Anchorage, AK 99508
Phone (907) 264-1222

14700 28th Ave N
Ste 20
Plymouth, MN 55447
Phone (612) 559-3779

Organizations & group practices 1

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 1

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": "1364342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672185600000",
    "number": "1841533924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6620 LAWLOR CIR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995021961",
            "telephone_number": "206-225-4013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6620 LAWLOR CIR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995021961",
            "telephone_number": "206-225-4013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVACK",
        "first_name": "HOLLY",
        "middle_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-27",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AK",
            "license": "ML125067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.