Individual provider Active NPI

Jennifer Lynn Vanyo-Novak, DO

  • Family Medicine Physician
  • Peoria, AZ
National Provider Identifier
1962665497
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
005562 Issued in AZ
Practice address
9000 W Thunderbird Rd Ste 110
Peoria, AZ 85381-4451
Phone
(557) 767-2668
NPI assigned
Jul 3, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R70147 AZ
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 005562 AZ Primary

Addresses

Primary practice location

9000 W Thunderbird Rd Ste 110
Peoria, AZ 85381-4451

Mailing address

9000 W Thunderbird Rd Ste 110
Peoria, AZ 85381-4451
Phone (557) 767-2668

Other identifiers 1

IdentifierTypeStateIssuer
102156MedicaidAZ

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
I20160118000483 AZ Practitioner - Family Practice 8729252747 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11634CAMDAcupuncturist
R70147AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Squaw Peak Family Physicians PC Multi-Specialty Current Accepting new patients
Honorhealth Ambulatory Multi-Specialty Current Accepting new patients
Honorhealth Ambulatory Multi-Specialty CurrentSince Jun 24, 2017 Accepting new patients
Honorhealth Medical Group, LLC Family Medicine CurrentSince Jan 11, 2016 Accepting new patients
Honorhealth Medical Group, LLC Multi-Specialty Current Accepting new patients
Honorhealth Medical Group, LLC Multi-Specialty Current Accepting new patients
Honorhealth Medical Group, LLC Multi-Specialty CurrentSince Jan 11, 2016 Accepting new patients
Honorhealth Ambulatory CurrentSince Jun 24, 2017 Accepting new patients

Locations

3648 W Anthem Way
Ste A100
Anthem, AZ 85086
Phone (623) 434-6444

4712 E Dynamite Blvd
Cave Creek, AZ 85331
Phone (480) 342-8711

6220 W Bell Rd
Ste 130
Glendale, AZ 85308
Phone (602) 547-7348

1610 W Glendale Ave
#128
Phoenix, AZ 85021
Phone (623) 780-1999

18404 N Tatum Blvd
Ste 101
Phoenix, AZ 85032
Phone (602) 992-1900

9327 N 3rd St
Ste 100
Phoenix, AZ 85020
Phone (602) 371-3100

4131 N 24th St
Ste B102
Phoenix, AZ 85016
Phone (602) 955-6632

2500 W Utopia Rd
Ste 100
Phoenix, AZ 85027
Phone (623) 683-4462

10510 N 92nd St
Ste 200
Scottsdale, AZ 85258
Phone (480) 323-1250

34525 N Scottsdale Rd
Scottsdale, AZ 85266
Phone (480) 882-7550

Interoperability endpoints

  • Direct secure messaging: jennifer.vanyo-novak.1@27165.direct.athenahealth.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.

NPI Registry JSON

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1962665497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W THUNDERBIRD RD STE 110",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814451",
            "telephone_number": "557-767-2668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 W THUNDERBIRD RD STE 110",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814451",
            "telephone_number": "557-767-2668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANYO-NOVAK",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-03",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "R70147",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "005562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102156",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.