Individual provider Active NPI

Stephen Bruce Novak, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Hollywood, FL
National Provider Identifier
1972516680
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
ME 0021354 Issued in FL
Practice address
1150 N 35TH Ave
#590
Hollywood, FL 33021
Phone
(954) 963-7191
Fax
(954) 894-3320
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X ME 0021354 FL Primary

Addresses

Primary practice location

1150 N 35TH Ave
#590
Hollywood, FL 33021

Mailing address

1150 N 35TH Ave
#590
Hollywood, FL 33021
Phone (954) 963-7191

Other identifiers 1

IdentifierTypeStateIssuer
78121OtherBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 0021354FLMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jellinger & Lerman, MD, LLC Endocrinology, Diabetes & Metabolism PastSince Sep 15, 2005 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972516680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 N 35TH AVE",
            "address_2": "#590",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "33021",
            "telephone_number": "954-963-7191",
            "fax_number": "954-894-3320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 N 35TH AVE",
            "address_2": "#590",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "33021",
            "telephone_number": "954-963-7191",
            "fax_number": "954-894-3320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVAK",
        "first_name": "STEPHEN",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "ME 0021354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "78121",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.