Physician Compare National (NPI:1699971705)

HEALTHCARE PROVIDER: RICHARD CLARENCE NOVACK JR. M.D.

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

Individual Professional Information
NPI	1699971705
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5496911372
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20161202000675
	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	RICHARD
	Individual professional first name
Provider Name Suffix Text	JR.
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	RUTGERS NEW JERSEY MEDICAL SCHOOL
	Individual professional's medical school
Graduation Year	2007
	Individual professional's medical school graduation year
Primary Specialty	GENERAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	LAPAROSCOPY BARIATRICS AND SURGERY PA
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	5294799060
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	4
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	2501 PARKVIEW DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 560
	Group Practice or individual's line 2 address
City	FORT WORTH
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	761025825
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8178501100
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450883
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	BAYLOR MEDICAL CENTER AT TROPHY CLUB
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y