Eric A Kivisto, DO is a medicare enrolled "Surgery" physician in Mendota, Illinois. His current practice location is
1405 E 12th St, Suite 500, Mendota, Illinois. You can reach out to his office (for appointments etc.) via phone at
(815) 539-1789.
Eric A Kivisto is licensed to practice in Illinois (license number 036091073) 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 1447257316.
Physician's Profile
Full Name | Eric A Kivisto |
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Gender | Male |
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Speciality | |
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Experience | Years |
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Location | 1405 E 12th St, Mendota, Illinois |
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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:
- Eric A Kivisto attended and graduated from in
NPI Data:
- NPI Number: 1447257316
- Provider Enumeration Date: 07/06/2005
- Last Update Date: 12/07/2022
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Eric A Kivisto such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1447257316 | NPI | - | NPPES |
371342699 | Other | IL | FEIN NUMBER |
036091073 | Medicaid | IL | |
02706617 | Other | IL | BLUE CROSS/BLUE SHIELD |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208600000X | Surgery | 5101011210 (Michigan) | Secondary |
208600000X | Surgery | 036091073 (Illinois) | Primary |
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. Eric A Kivisto 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 |
Eric A Kivisto, DO 1401 E 12th St, Mendota, IL 61342-9216 Ph: (815) 539-1789 | Eric A Kivisto, DO 1405 E 12th St, Suite 500, Mendota, IL 61342-9010 Ph: (815) 539-1789 |
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