Physician Compare National (NPI:1598762924)

HEALTHCARE PROVIDER: BRIAN NOVACK DPM

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1598762924
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4284795311
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20081209000127
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	NOVACK
	Individual professional last name
Provider First Name	BRIAN
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	KENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE
	Individual professional's medical school
Graduation Year	1996
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	29630 EUCLID AVE
	Group Practice or individual's line 1 address
City	WICKLIFFE
	Group Practice or individual's city
State	OH
	Group Practice or individual's state
Zip Code	440921829
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	360144
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SOUTH POINTE HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	360180
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CLEVELAND CLINIC
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y