IVANA MITIC (CRNA) – Psychiatric/Mental Health Nurse Practitioner, NPI 1962743815

IVANA MITIC (CRNA) is a healthcare provider. based in Marion, Illinois. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA), NURSE PRACTITIONER. They hold the professional credentials CRNA. They hold a License No. 784417 (TX). The NPI Number for IVANA MITIC (CRNA) is 1962743815

Main info

Female
Sole Proprietor
14 Years Of Experience
Accepts Medicare Assignment
Name
IVANA MITIC (CRNA)
NPI
1962743815
Phone
Not provided
Address
1702 E BOYTON ST APT B
Enumeration Date
1 March 2013
Last Update Date
28 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4108705482
Graduation Year
2012 (14 years ago)
PAC ID
1355580317
Group Practice PAC ID
9739568569
Professional Enrollment ID
I20230515002400
Address ID
MD211529476SP909XXRDXX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:13State licenses:2Digital endpointsOther names

2,265 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in IL

Provider Addresses for IVANA MITIC (CRNA)

  • 1702 E BOYTON ST APT B

    MARION, IL 629594332

    Phone:

    Type: Mailing

  • 1616 W MAIN ST STE 508

    MARION, IL 629591146

    Phone: (618) 997-1122

    Type: Location

  • 2324 N Zion Rd Ste 113

    Salisbury, MD 218012576

    Phone: (410) 870-5482

    Type: Location

  • 909 RIDGEBROOK RD STE 202

    SPARKS, MD 211529476

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $77.

Total Amount is formed as General ($77) + Research ($0) + Ownership ($0) = $77.

Last reported payment date: 2024-10-15 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($77).

Total Amount

$77

General + Research + Ownership

Payments

3

Total payment records

General Amount

$77

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-15

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2023-05-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20141216001308ICertified Registered Nurse Anesthetist (Crna)MDTBD
I20230515002400INurse PractitionerMDTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
G2212Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or15114$0
99215Established patient office or other outpatient visit, 40-54 minutes3614$0
View full utilization report →

Insurance plans in this area (ZIP 62959)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9739568569View full group profile
NameSpecialtyState
Nurse PractitionerMD
P S Y C H I A T R YMD

Reviews

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Frequently asked questions

What NPI should I save for IVANA MITIC (CRNA)?
Save NPI 1962743815 if you need a stable reference for IVANA MITIC (CRNA).
Is IVANA MITIC (CRNA)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize IVANA MITIC (CRNA)'s specialty in plain language?
Clinically, the directory lists IVANA MITIC (CRNA) with Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is IVANA MITIC (CRNA)'s primary listing?
We display Marion, Illinois because that is what the record indicates for IVANA MITIC (CRNA).
How can I contact IVANA MITIC (CRNA)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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