NICOLE NOVAK – Occupational Therapist, NPI 1104434885

NICOLE NOVAK is a healthcare provider. based in Lansing, Michigan. specializing in OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE. They hold a License No. 5201013674 (MI). The NPI Number for NICOLE NOVAK is 1104434885

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
NICOLE NOVAK
NPI
1104434885
Phone
(517) 708-8557
Address
1048 Pierpont Dr Ste 9
Enumeration Date
17 July 2020
Last Update Date
3 April 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8774073422
Graduation Year
2023 (3 years ago)
PAC ID
5294264396
Group Practice PAC ID
2769819960
Professional Enrollment ID
I20250117001596
Address ID
MI481872757CA5969XRDXX500

Contacts

Main Contact
https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness95
Years active:5State licenses:1Other names

711 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in MI

Provider Addresses for NICOLE NOVAK

  • 1048 Pierpont Dr Ste 9

    Lansing, MI 489115976

    Phone: (517) 708-8557

    Type: Location

  • 1048 PIERPONT DR STE 9

    LANSING, MI 489115976

    Phone: (517) 708-8557

    Type: Location

  • 5969 N CANTON CENTER RD

    CANTON, MI 481872757

    Phone: (877) 407-3422

    Fax: (877) 407-4329

    Type: Location

  • 701 SNOW RD STE A

    LANSING, MI 489174087

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-01-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250117001596IOccupational Therapist In Private PracticeMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48911)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2769819960View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeMI
Occupational Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Occupational Therapist In Private PracticeNJ
Qualified Speech Language PathologistIN
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeGA
-MI
Physical Therapist In Private PracticeMI
Occupational Therapist In Private PracticeMI

Reviews

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Frequently asked questions

Can I use this page to confirm NICOLE NOVAK's NPI?
Yes. NICOLE NOVAK is listed with NPI 1104434885 in the public NPI dataset.
Can I rely on NICOLE NOVAK being an active provider?
As of the registry snapshot, NICOLE NOVAK is marked active.
What healthcare role does NICOLE NOVAK hold?
Scheduling teams often label NICOLE NOVAK under Occupational Therapist. Clinical services aligned with this taxonomy classification.
Where is NICOLE NOVAK based?
NICOLE NOVAK is tied to Lansing, Michigan in the data we show; additional addresses may exist on the full record.
Is the information about NICOLE NOVAK up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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