Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1669096111 Individual Practitioner Male Practitioner

Dr. Jacob Alexander Martin Novack , DO

Urology • Port Huron, MI

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Jacob Novack, DO is a certified Urology practicing in Port Huron, MI. With approximately 6 years of clinical experience since completing medical education in 2020, Dr. Novack delivers high-quality medical care to the local community at 1037 WATER ST STE 1.

Dr. Novack is affiliated with Mclaren Medical Group and accepts Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

1037 Water St Ste 1

Port Huron, MI 480604408

Telephone 2489677000
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Other

Graduation Year

2020

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Urology in Port Huron, MI

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
6 Yrs -18.6 yrs vs City Avg
City Avg: 24.6 Yrs
State Avg: 25.6 Yrs
Regional Practice Density
6 Specialists

Practicing in Port Huron, MI (479 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Novack (6 Years) 6 Yrs
Port Huron Specialty Average (24.6 Years) 24.6 Yrs

Medical Specialties & State Licenses

CMS Verified: 2025-10-14
Urology Primary Specialty

NUCC Taxonomy Code: 208800000X

State License MI 5101028607

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

Hospital & Practice Group Affiliations

Mclaren Medical Group

1037 Water St, Port Huron, MI 480604408

Phone: 8109844194

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

9 Associated Practitioners
Dr. Lisa Wargo , DNP

Nurse Practitioner - Acute Care

NPI 1003288226

Doctor of Nursing Practice

Dr. Elizabeth Marcuz , DO

Emergency Medicine

NPI 1093001075

Doctor of Osteopathic Medicine (D.O.)

Christina Audia , AGACNP-BC

Nurse Practitioner - Acute Care

NPI 1215603428

Adult-Gerontology Acute Care Nurse Practitioner (Board Certified)

NPI 1356457469

Doctor of Osteopathic Medicine (D.O.)

Tina Moran , ACNP

Nurse Practitioner - Acute Care

NPI 1407042930
Marnie Fuerth

Registered Nurse

NPI 1548404510

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 14, 2025

Urology (License #5101028607 in MI)

📍
Updated Practice Location July 09, 2025

Registered at 1037 WATER ST STE 1, PORT HURON, MI 480604408 (Tel: 2489677000)

📍
Updated Business Mailing Address July 09, 2025

Registered at 22644 RIDGEWAY ST, SAINT CLAIR SHORES, MI 480801476 (Tel: 5862162615)

NPI Profile Active June 01, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location June 01, 2020

Registered at 27351 DEQUINDRE RD, MADISON HEIGHTS, MI 480713487 (Tel: 2489677000)

📍
Updated Business Mailing Address June 01, 2020

Registered at 26460 BELANGER ST, ROSEVILLE, MI 480663162 (Tel: 5862162615)

👤
Provider Name / Credentials Updated June 01, 2020

Recorded as JACOB NOVACK, DO

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 01, 2020

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration June 01, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1669096111
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 01, 2020
Last Update: October 14, 2025
Sole Proprietor: No

Mailing Address

22644 Ridgeway St

Saint Clair Shores, MI 480801476

Phone: 5862162615

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.