JACOB ALEXANDER MARTIN NOVACK (DO) – Urology Physician, NPI 1669096111
Urology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
469 UROLOGY in MI
Provider Addresses for JACOB ALEXANDER MARTIN NOVACK (DO)
26460 BELANGER ST
ROSEVILLE, MI 480663162
Phone: (586) 216-2615
Type: Mailing
27351 DEQUINDRE RD
MADISON HEIGHTS, MI 480713487
Phone: (248) 967-7000
Type: Location
22644 RIDGEWAY ST
SAINT CLAIR SHORES, MI 480801476
Phone: (586) 216-2615
Type: Mailing
1037 WATER ST STE 1
PORT HURON, MI 480604408
Phone: (248) 967-7000
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $485.
Total Amount is formed as General ($485) + Research ($0) + Ownership ($0) = $485.
Last reported payment date: 2024-10-28 • Largest payer in this snapshot: Photocure Inc ($134).
Total Amount
$485
General + Research + Ownership
Payments
5
Total payment records
General Amount
$485
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-28
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Photocure Inc | $134 |
| Ferring Pharmaceuticals Inc. | $130 |
| UROGEN PHARMA, INC. | $121 |
| Axonics, Inc. | $100 |
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: 2025-10-09
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20251009000897 | I | Urology | MI | TBD |
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.
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 48066)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | MI | |
| Emergency Medicine | MI | |
| Emergency Medicine | MI | |
| Family Practice | MI | |
| Emergency Medicine | IL | |
| - | GA | |
| Emergency Medicine | MI | |
| Emergency Medicine | MI | |
| Physician Assistant | MI | |
| - | MI |
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