Brian J Novack DPM Inc

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

36-002998N Issued in OH

Legal business name

BRIAN J NOVACK DPM INC

Practice address

20050 Harvard Ave Ste 105
Warrensville Heights, OH 44122-6800

Phone

(216) 491-9151

Fax

(216) 491-7243

NPI assigned

Jan 23, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Brian J Novack, DPMNPI 1598762924

Title

Podiatrist

Phone

(216) 491-9151

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Brian J Novack DPM Inc

  • Podiatrist
  • Wickliffe, OH
  • NPI 1134273428

  4183785215

  Same PAC ID

Tax ID family

Brian J Novack DPM Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Brian J Novack DPM

  • Foot Surgery Podiatrist
  • Wickliffe, OH
  • NPI 1316092844
  NPD tax ID
• Brian J Novack DPM Inc

  • Podiatrist
  • Wickliffe, OH
  • NPI 1134273428
  NPD tax ID

Practitioners 2

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

• Brian Novack, DPM

  • Podiatrist
  • Wickliffe, OH
  • NPI 1598762924
  NPD Authorized official
• Joel Novack, DPM

  • Podiatrist
  • Warrensville Heights, OH
  • NPI 1053349894
  NPD (past)

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675814400000",
    "number": "1861546954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29630 EUCLID AVE",
            "city": "WICKLIFFE",
            "state": "OH",
            "postal_code": "440921829",
            "telephone_number": "440-944-6665",
            "fax_number": "440-944-6672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20050 HARVARD AVE STE 105",
            "city": "WARRENSVILLE HEIGHTS",
            "state": "OH",
            "postal_code": "441226800",
            "telephone_number": "216-491-9151",
            "fax_number": "216-491-7243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN J NOVACK DPM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A",
        "authorized_official_last_name": "NOVACK",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "216-491-9151",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "OH",
            "license": "36-002998N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2146270",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Brackney, DVM
• Madelyn Braman, PHARMD
• Deandre Branner
• Megan Braund, PHARMD
• Zachary Breeden, DO
• Bright Prosthetics Inc.
• Latina Brooks, CNP, PHD
• Colin R Brown, DO
• Kquawan Brown
• Michelle Brown

• Foot Surgery Podiatrist in Warrensville Heights, OH
• Providers in Warrensville Heights, OH by specialty
• Foot Surgery Podiatrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; 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.