Individual provider Active NPI

Stuart N. Novack, M.D.

  • Rheumatology Physician
  • Norwalk, CT
National Provider Identifier
1972595494
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
015540 Issued in CT
Practice address
761 Main Ave
Norwalk, CT 06851-1080
Phone
(203) 852-2290
Fax
(203) 899-5029
NPI assigned
Aug 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 015540 CT
Rheumatology Physician 207RR0500X 015540 CT Primary

Addresses

Primary practice location

761 Main Ave
Norwalk, CT 06851-1080

Mailing address

761 Main Ave Ste 112
Norwalk, CT 06851-1080
Phone (203) 852-2290

Other identifiers 2

IdentifierTypeStateIssuer
001155407MedicaidCT
1972595494MedicaidDC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20100415000764 CT Practitioner - Rheumatology 3476642554

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 1966
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

40 Cross St
Norwalk, CT 06851-4647

40 Cross St
Norwalk, CT 06851-4661

Hospital & facility affiliations

  • Danbury Hospital Hospital, Danbury, CT, CCN 070033
  • Norwalk Hospital Hospital, Norwalk, CT, CCN 070034

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
015540CTMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvance Health Medical Practice CT, Inc. Internal Medicine CurrentSince Feb 28, 2019 Accepting new patients

Locations

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

40 Cross St
Ste 4
Norwalk, CT 06851
Phone (203) 845-2000

761 Main Ave
Norwalk, CT 06851
Phone (203) 845-2160

40 Cross St
#4
Norwalk, CT 06851

761 Main Ave
Ste 112
Norwalk, CT 06851
Phone (203) 505-3997

40 Cross St
Fl 4
Norwalk, CT 06851
Phone (203) 845-4800

520 West Ave
Norwalk, CT 06850
Phone (203) 852-2417

40 Cross St
Norwalk, CT 06851
Phone (203) 845-2020

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 6

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": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1972595494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "761 MAIN AVE STE 112",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068511080",
            "telephone_number": "203-852-2290",
            "fax_number": "203-899-5029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "761 MAIN AVE",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068511080",
            "telephone_number": "203-852-2290",
            "fax_number": "203-899-5029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVACK",
        "first_name": "STUART",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "015540",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CT",
            "license": "015540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001155407",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972595494",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

Verify at the official NPI Registry.