Individual provider Active NPI

Nova Michele Foster, MD

  • Surgery Physician
  • Carbondale, IL
National Provider Identifier
1902829567
Registry record updated Apr 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
036.134717 Issued in IL
Practice address
1237 E Main St
Suite C
Carbondale, IL 62901-3148
Phone
(618) 457-2281
Fax
(618) 529-0573
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A65913 CA
Surgery Physician 208600000X 036.134717 IL Primary

Addresses

Primary practice location

1237 E Main St
Suite C
Carbondale, IL 62901-3148

Mailing address

PO Box 1105
Indianapolis, IN 46206-1105
Phone (618) 457-5200

Other identifiers 1

IdentifierTypeStateIssuer
00A659130MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20190206002113 AZ Practitioner - General Surgery 5294881652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Vanderbilt University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner-University Medical GroupGroup PAC ID 7719899871, 1,066 clinicians

Practice addresses (Care Compare)

3838 N Campbell Ave
BLDG 1
Tucson, AZ 85719-1454
Phone (520) 694-2873

Hospital & facility affiliations

  • Banner - University Medical Center Tucson Campus Hospital, Tucson, AZ, CCN 030064

Merit-based Incentive Payment System (MIPS)

Final score
93.34 of 100Reported as apm
Quality
74.56
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy43
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.134717ILMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group CurrentSince Dec 1, 2018 Accepting new patients
Banner-University Medical Group CurrentSince Dec 1, 2018 Accepting new patients

Locations

3533 Canyon de Flores
Ste C
Sierra Vista, AZ 85650
Phone (520) 458-2000

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

1625 N Campbell Ave
Tucson, AZ 85719

1891 W Orange Grove Rd
Bldg 1
Tucson, AZ 85704
Phone (520) 694-2873

3838 N Campbell Ave
Tucson, AZ 85719
Phone (520) 694-2873

3838 N Campbell Ave
Bldg 1
Tucson, AZ 85719
Phone (520) 694-2873

Organizations & group practices 2

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 2

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397779200000",
    "number": "1902829567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1105",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462061105",
            "telephone_number": "618-457-5200",
            "fax_number": "618-351-6486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1237 E MAIN ST",
            "address_2": "SUITE C",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629013148",
            "telephone_number": "618-457-2281",
            "fax_number": "618-529-0573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSTER",
        "first_name": "NOVA",
        "middle_name": "MICHELE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2014-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A65913",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036.134717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A659130",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

Verify at the official NPI Registry.