DR. DMITRY FAMILTSEV (M.D., PH.D.) – Interventional Cardiology Physician, NPI 1194161174
Interventional Cardiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
783 CARDIOVASCULAR DISEASE (CARDIOLOGY) in MO
Provider Addresses for DR. DMITRY FAMILTSEV (M.D., PH.D.)
1050 W 10TH ST
ROLLA, MO 654012905
Phone: (573) 426-2182
Fax: (573) 426-5341
Type: Mailing
1501 N Campbell Ave
Tucson, AZ 857240001
Phone: (520) 626-1416
Fax: (520) 626-4333
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 14 Open Payments records for all available years, with a total value of $483.
Total Amount is formed as General ($483) + Research ($0) + Ownership ($0) = $483.
Last reported payment date: 2024-02-01 • Largest payer in this snapshot: Boston Scientific Corporation ($142).
Total Amount
$483
General + Research + Ownership
Payments
14
Total payment records
General Amount
$483
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-02-01
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2023-11-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20231117001482 | I | Cardiovascular Disease (Cardiology) | AZ | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 93010 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 1,633 | 1,224 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 988 | 785 | $0 |
| 93306 | Ultrasound of heart with color-depicted blood flow, rate, direction and valve function | 380 | 368 | $0 |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 257 | 102 | $0 |
| 93296 | Evaluation of single, dual, multiple lead or leadless pacemaker system or implantable defibrillator system, remote up to 90 days | 140 | 101 | $0 |
Insurance plans in this area (ZIP 65401)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine, Cardiovascular Disease (Cardiology) | AZ | |
| - | AZ | |
| Internal Medicine | AZ | |
| U R O L O G Y | NC | |
| Nurse Practitioner | AZ | |
| Physician Assistant | AZ | |
| Family Practice | WV | |
| Interventional Cardiology, Internal Medicine | AZ | |
| N E U R O L O G Y | AZ | |
| - | AZ |
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