Gregory Daniel Novak, MD is a medicare enrolled "Pathology - Anatomic Pathology & Clinical Pathology" physician in Cottonwood, Arizona. His current practice location is
269 S Candy Ln, Cottonwood, Arizona. You can reach out to his office (for appointments etc.) via phone at
(928) 639-6180.
Gregory Daniel Novak is licensed to practice in Arizona (license number 41896) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1275511156.
Physician's Profile
Full Name | Gregory Daniel Novak |
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Gender | Male |
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Speciality | Pathology - Anatomic Pathology & Clinical Pathology |
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Location | 269 S Candy Ln, Cottonwood, Arizona |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1275511156
- Provider Enumeration Date: 01/03/2006
- Last Update Date: 01/07/2016
Medicare PECOS Information:
- PECOS PAC ID: 4183602097
- Enrollment ID: I20090727000625
Medical Identifiers
Medical identifiers for Gregory Daniel Novak such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1275511156 | NPI | - | NPPES |
Z154190 | Other | AZ | MEDICARE PTAN |
036655200 | Medicaid | MN | |
438736 | Medicaid | AZ | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207ZP0105X | Pathology - Clinical Pathology/laboratory Medicine | 46598 (Minnesota) | Secondary |
207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 41896 (Arizona) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Gregory Daniel Novak allows following entities to bill medicare on his behalf.
Entity Name | Banner -- University Medical Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1508809427 PECOS PAC ID: 7719899871 Enrollment ID: O20031105000694 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Gregory Daniel Novak is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Gregory Daniel Novak, MD 1200 N Beaver St, Payer Credentialing, Flagstaff, AZ 86001-3118 Ph: (928) 773-2559 | Gregory Daniel Novak, MD 269 S Candy Ln, Cottonwood, AZ 86326-4158 Ph: (928) 639-6180 |
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