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DR. MATTHEW JOHN NOVAK MD
NPI 1871775122
Internal Medicine - Nephrology in Mount Vernon, WA

Active since November 28, 2007PECOS EnrolledAccepts Medicare Assignment
87.04/100
CMS Quality Rating
208 HOSPITAL PKWY, MOUNT VERNON, WA 98274(360) 428-2550(360) 814-8390 Get Directions Write a Review

NPPES record last updated: November 5, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Matthew John Novak Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MATTHEW JOHN NOVAK MD (NPI 1871775122) is an individual nephrology provider in Mount Vernon, Washington, licensed in Washington (MD60878072) and active in the NPI registry since November 2007. He is enrolled in Medicare PECOS, is affiliated with Our Lady Of Lourdes Memorial Hospital, Inc, and is a graduate of Drexel University College Of Medicine (2003).

NPPES Registry Identity

NPI1871775122
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameDR. MATTHEW JOHN NOVAKCredential: MD
Location Address208 HOSPITAL PKWYMount Vernon, WA 98274
Mailing Address1400 E Kincaid St, Attn: CredentialingMount Vernon, WA 98274-4127 · (360) 428-2500
Phone(360) 428-2550
Fax(360) 814-8390
Sole ProprietorNo
Medical School CMSDrexel University College Of MedicineGraduated 2003
Enumeration DateNovember 28, 2007
Last NPPES UpdateNovember 5, 2018
✔ NPI 1871775122 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License✔ Licensed in WA · MD60878072
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
208 HOSPITAL PKWY, Mount Vernon, WA 98274
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Other Identifiers 4

Medicaid02985266NY
Medicaid2107794WA
OtherGU040072PA · Pa Medicare Group
Medicaid1021675260001PA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Matthew John Novak Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID941374110
PECOS Enrollment IDI20080806000289, I20190111002318, I20231010000504
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Matthew Novak reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Public Hospital Dist No 1 Skagit
0.2 mi
General Practice
1400 E KINCAID ST
Mount Vernon, WA 98274
  • Reassigned Medicare billing, Washington enrollment
  • 463 clinicians in this Medicare group
NPI 1023332749 (360) 428-2500
Guthrie Medical Group, P.C.
2,215 mi
Multi-Specialty
130 CENTERWAY
Corning, NY 14830
  • Reassigned Medicare billing, New York and Pennsylvania enrollments
  • Medicare enrollment name: Guthrie Medical Group PC
  • Also billed through NPI 1952350167 (Pennsylvania)
  • 798 clinicians in this Medicare group
NPI 1134178635 (607) 936-9971

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
245 services194 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
223 services85 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
215 services117 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
214 services129 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
104 services104 patients
Hemodialysis procedure with physician evaluation 90935
Hemodialysis is a treatment that uses a machine to filter waste and excess fluid from your blood when your kidneys can't. A physician checks your health before, during, and after the procedure to ensure it's working effectively for you.
96 services36 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Our Lady Of Lourdes Memorial Hospital, Inc

Acute Care Hospitals · Binghamton, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330011
Location169 Riverside DriveBinghamton, NY 13905 · Broome County
Emergency services Birthing friendly

Corning Hospital

Acute Care Hospitals · Corning, NY
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330277
Location1 Guthrie DriveCorning, NY 14830 · Steuben County
Emergency services Birthing friendly

Robert Packer Hospital

Acute Care Hospitals · Sayre, PA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390079
LocationOne Guthrie SquareSayre, PA 18840 · Bradford County
Emergency services Birthing friendly

Skagit Valley Hospital

Acute Care Hospitals · Mount Vernon, WA
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number500003
Location1415 E Kincaid StreetMount Vernon, WA 98274 · Skagit County
Emergency services Birthing friendly

Whidbeyhealth Medical Center

Critical Access Hospitals · Coupeville, WA
1/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number501339
Location101 North Main StreetCoupeville, WA 98239 · Island County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98274 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$130.99 typical visit price
range $57.27 – $172.80
Typical copayment $32.74 (range $14.31 – $43.20)
Most-billed visit code 99204
Established Patient
$100.78 typical visit price
range $18.56 – $141.11
Typical copayment $25.19 (range $4.64 – $35.27)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

87.04/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality100
Improvement Activities0
Cost90.14

Referred Medical Equipment & Supplies CMS DME claims 7

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tacrolimus, immediate release, oral, 1 mg J7507
Treatment-Treatment - Miscellaneous · category RX029N
7 suppliers31 claims2,760 services$0.32 avg. paid by Medicare
Prednisone, immediate release or delayed release, oral, 1 mg J7512
Treatment-Treatment - Miscellaneous · category RX029N
4 suppliers25 claims3,750 services$0.01 avg. paid by Medicare
Cyclosporine, oral, 25 mg J7515
Treatment-Treatment - Miscellaneous · category RX029N
1 supplier13 claims3,120 services$0.55 avg. paid by Medicare
Mycophenolate mofetil, oral, 250 mg J7517
Treatment-Treatment - Miscellaneous · category RX029N
2 suppliers21 claims4,080 services$0.20 avg. paid by Medicare
Mycophenolic acid, oral, 180 mg J7518
Treatment-Treatment - Miscellaneous · category RX029N
2 suppliers17 claims1,680 services$1.01 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511
Treatment-Chemotherapy · category RH012N
9 suppliers34 claims34 services$18.93 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Matthew Novak's NPI number?

The NPI number for Matthew Novak is 1871775122. It was assigned to this individual provider in the NPPES registry on November 28, 2007.

Where is Matthew Novak located?

Matthew Novak practices at 208 Hospital Pkwy, Mount Vernon, WA 98274. The listed phone number is (360) 428-2550.

What is Matthew Novak's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Matthew Novak enrolled in Medicare?

Yes. Matthew Novak is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Matthew Novak's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Matthew Novak reassigns Medicare benefits to 2 organizations: Public Hospital Dist No 1 Skagit (Mount Vernon, WA) and Guthrie Medical Group, P.C. (Corning, NY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Matthew Novak's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Matthew Novak accept?

Health plans from Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Matthew Novak as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Matthew Novak affiliated with any hospitals?

According to CMS data, Matthew Novak is affiliated with Our Lady Of Lourdes Memorial Hospital, Inc, Corning Hospital, Robert Packer Hospital, Skagit Valley Hospital and Whidbeyhealth Medical Center.

When was this NPI record last updated?

The NPPES record for Matthew Novak was last updated on November 5, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.