DR. DONALD E NOVICKI (NPI# 1013992312) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013992312 |
| Entity Type | Individual |
| Full Name | DR. DONALD E NOVICKI |
| Credential | M.D. |
| Practice Address |
5779 E Mayo Blvd Phoenix AZ 85054-4502 |
| Practice Telephone | 4803018000 |
| Mailing Telephone | 4803018000 |
| Enumeration Date | 2005-12-08 |
| Last Update Date | 2007-10-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 21486 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 336215 | 05 | |
| AZ | TRIWEST | 86080015085259A343 | 01 |
| Street Address |
5779 E MAYO BLVD |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85054-4502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043219389 | Hasan Khamash | Internal Medicine | 5779 E Mayo Blvd, Phoenix, AZ 85054 | 2005-07-19 |
| 1831709393 | Sarah Jayne Refner | Nurse Practitioner | 5779 E Mayo Blvd, Phoenix, AZ 85054-4502 | 2020-08-08 |
| 1780215616 | Amy Kole | Physician Assistant | 5779 E Mayo Blvd, Phoenix, AZ 85054-4502 | 2020-01-29 |
| 1174083075 | Jee Kim | Student in an Organized Health Care Education/Training Program | 5779 E Mayo Blvd, Phoenix, AZ 85054-4502 | 2019-03-25 |
| 1902315435 | Stacie Attig | Registered Nurse | 5779 E Mayo Blvd, Phoenix, AZ 85054 | 2017-09-27 |
| 1386906667 | Rudy Rahme | Neurological Surgery | 5779 E Mayo Blvd, Phoenix, AZ 85054-4502 | 2012-06-12 |
| 1083904221 | Deborah S Dossick | Student in an Organized Health Care Education/Training Program | 5779 E Mayo Blvd, Phoenix, AZ 85054-4502 | 2011-04-08 |
| 1477863298 | Shari T Perez | Nurse Practitioner | 5779 E Mayo Blvd, Phoenix, AZ 85054 | 2010-10-14 |
| 1427367473 | Shawna Sando Boyle | Physician Assistant | 5779 E Mayo Blvd, Phoenix, AZ 85054-4502 | 2010-09-24 |
| 1851609309 | Jaime L Engholdt | Physician Assistant | 5779 E Mayo Blvd, Phoenix, AZ 85054-4502 | 2010-09-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992255301 | Stephanie Gamber | Registered Nurse | 5405 East Pinnacle Vista Drive, Phoenix, AZ 85054 | 2016-10-10 |
| 1508231960 | Deborah Elam | Acupuncturist | 5777 East Mayo Boulevard Mayo Clinic, Phoenix, AZ 85054 | 2015-12-09 |
| 1811176860 | Desert Ridge Pediatric Dentistry | Clinic/Center | 5315 E. High Street, Suite 115, Phoenix, AZ 85054 | 2007-10-26 |
| 1902968639 | Ryan David Schulze | Chiropractor | 7000 E Mayo Blvd Ste 1058, Phoenix, AZ 85054 | 2006-12-16 |
| 1477517423 | Gary Betz II Md PC | Internal Medicine | 7010 E. Chauncey Lane, Suite 145, Phoenix, AZ 85054 | 2006-04-14 |
| 1689658395 | Alice G Mccormick | Internal Medicine | 5450 East Deer Valley Drive Unit 3206, Phoenix, AZ 85054 | 2005-12-06 |
| 1770576241 | Michelle Renee Kuhn | Physician Assistant | 6950 E Chauncey Ln, Phoenix, AZ 85054 | 2005-08-30 |
| 1609869981 | Jeffrey Alan Smith | Optometrist | 18325 N Allied Way Ste 100, Phoenix, AZ 85054 | 2005-08-23 |
| 1497753750 | Rajeev Agarwal | Pediatrics | 7010 E Chauncey Ln, Suite 225, Phoenix, AZ 85054 | 2005-07-11 |
| 1740283878 | Charles J Manak | Internal Medicine | 5777 E Mayo Blvd, Phoenix, AZ 85054 | 2005-05-23 |
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| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558879759 | Alliance Oncology of Arizona, LLC | Urology | 2525 E Arizona Biltmore Cir Ste C236, Phoenix, AZ 85016-2130 | 2018-01-22 |
| 1912327198 | Kris Miguel Cajipe | Urology | 15920 S 48th St Ste 100, Phoenix, AZ 85048-1003 | 2014-04-25 |
| 1841610003 | Elizabeth Ashley Tourville | Urology | 1313 E Osborn Rd Ste B-150, Phoenix, AZ 85014-5678 | 2014-04-25 |
| 1487090288 | Jack W Grinnan | Urology | 19841 N 27th Ave Ste 201, Phoenix, AZ 85027-4005 | 2013-05-20 |
| 1932378700 | Kevin R Bigelow | Urology | 15920 S. 48th Street, Suite 100, Phoenix, AZ 85048-1003 | 2008-02-26 |
| 1922205186 | Daniel Young Woodruff | Urology | 2444 W. Las Palmaritas Dr, Mail Stop A 112, Phoenix, AZ 85021 | 2007-06-29 |
| 1265588859 | Lauren Byrne | Urology | 15920 S 48th St, Suite 100, Phoenix, AZ 85048-1003 | 2007-01-26 |
| 1376576348 | Prostate Solutions of Arizona, P.C. | Urology | 1 E Camelback Rd, Suite 700, Phoenix, AZ 85012-1668 | 2006-07-10 |
| 1336181205 | Ilya A Volfson | Urology | 4530 E Ray Rd Ste 128, Phoenix, AZ 85044-6096 | 2006-06-12 |
| 1750320842 | Yoon Mark Hong | Urology | 2222 E Highland Ave Ste 206, Phoenix, AZ 85016 | 2006-06-05 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.