Individual provider Active NPI

Martin Ilan Noveck, MD

  • Pain Medicine (Anesthesiology) Physician
  • Clarkston, MI
National Provider Identifier
1972884724
Registry record updated Sep 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
4301045047 Issued in MI
Practice address
9255 Allen Rd
Clarkston, MI 48348-2726
Phone
(248) 922-0446
Fax
(248) 922-0448
NPI assigned
Sep 7, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 4301045047 MI Primary

Addresses

Primary practice location

9255 Allen Rd
Clarkston, MI 48348-2726

Mailing address

9255 Allen Rd
Clarkston, MI 48348-2726
Phone (248) 922-0446

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301045047MIMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bloomfield Anesthesia, PC Past 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": "1315353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315353600000",
    "number": "1972884724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9255 ALLEN RD",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483482726",
            "telephone_number": "248-922-0446",
            "fax_number": "248-922-0448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9255 ALLEN RD",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483482726",
            "telephone_number": "248-922-0446",
            "fax_number": "248-922-0448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVECK",
        "first_name": "MARTIN",
        "middle_name": "ILAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-07",
        "last_updated": "2011-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MI",
            "license": "4301045047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkston, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2011; 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.