Dr Dmitriy Stalivonenko, MD in Kenosha, WI

Dr Dmitriy Stalivonenko, MD is a medicare enrolled "Anesthesiology" physician in Kenosha, Wisconsin. He graduated from medical school in 1988 and has 36 years of diverse experience with area of expertise as Anesthesiology. He is a member of the group practice Aurora Medical Group, Inc. and his current practice location is 10400 75th St, Kenosha, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (414) 358-5443.

Dr Dmitriy Stalivonenko is licensed to practice in Wisconsin (license number 40879-020) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1710966395.

Contact Information

	Dr Dmitriy Stalivonenko, MD
	10400 75th St, Kenosha, WI 53142-7884
	(414) 358-5443
	Not Available

Map and Direction

Physician's Profile

Full Name	Dr Dmitriy Stalivonenko
Gender	Male
Speciality	Anesthesiology
Experience	36 Years
Location	10400 75th St, Kenosha, Wisconsin
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Dr Dmitriy Stalivonenko graduated from medical school in 1988

NPI Data:

NPI Number: 1710966395
Provider Enumeration Date: 01/12/2006
Last Update Date: 11/06/2023

Medicare PECOS Information:

PECOS PAC ID: 8921099144
Enrollment ID: I20100209000242

Medical Identifiers

Medical identifiers for Dr Dmitriy Stalivonenko such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1710966395	NPI	-	NPPES
34055600	Medicaid	WI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207L00000X	Anesthesiology	40879-020 (Wisconsin)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Aurora Medical Center Kenosha	Kenosha, WI	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Aurora Medical Group, Inc.	6709794258	3269

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Dmitriy Stalivonenko allows following entities to bill medicare on his behalf.

Entity Name	Aurora Medical Group, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Dmitriy Stalivonenko is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Dmitriy Stalivonenko, MD Po Box 735044, Chicago, IL 60673-5044 Ph: (414) 358-5443	Dr Dmitriy Stalivonenko, MD 10400 75th St, Kenosha, WI 53142-7884 Ph: (414) 358-5443

Reviews and Comments

Anesthesiology Doctors in Kenosha, WI

Dr. Rick J Hutson, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 6308 8th Ave, Kenosha, WI 53143 Phone: 262-656-2011
Marijan Jednacak, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 10400 75th St, Kenosha, WI 53142 Phone: 262-697-7000
Dr. Paul G Spottswood, M.D. Anesthesiology Medicare: Medicare Enrolled Practice Location: 6308 8th Ave, Kenosha, WI 53143 Phone: 262-656-2011
Faraz Ahmad Khan Daha, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 6815 118th Ave, Kenosha, WI 53142 Phone: 262-857-5600
Dr. Antonio C Caballero, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 10400 75th St, Kenosha, WI 53142 Phone: 262-697-7000
Timothy James Maher, Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 10400 75th St, Kenosha, WI 53142 Phone: 414-389-2131
Joseph M Duratinsky, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 6308 Eighth Ave, Kenosha, WI 53143 Phone: 262-656-2011 Fax: 262-439-7683

Dr Dmitriy Stalivonenko, MD - Medicare Anesthesiology in Kenosha, WI