SANDRA LEE MITKOS (FNP) – Family Nurse Practitioner, NPI 1790015527
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
7,017 NURSE PRACTITIONER in MO
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Provider Addresses for SANDRA LEE MITKOS (FNP)
Washington County Memorial Hospital, 300, Health Way Drive, Potosi, Washington County, Missouri, 63660, United States
POTOSI, MO 636641420
Phone: (573) 438-5451
Fax: (573) 438-2399
Type: Mailing
108, Frizzell Street, Potosi, Washington County, Missouri, 63664, United States
POTOSI, MO 636641505
Phone: (573) 438-5408
Fax: (573) 438-2419
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 43 Open Payments records for all available years, with a total value of $1,071.
Total Amount is formed as General ($1,071) + Research ($0) + Ownership ($0) = $1,071.
Last reported payment date: 2024-12-19 • Largest payer in this snapshot: ABBVIE INC. ($221).
Total Amount
$1,071
General + Research + Ownership
Payments
43
Total payment records
General Amount
$1,071
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $221 |
| Nevro Corp. | $172 |
| Lilly USA, LLC | $141 |
| Teva Pharmaceuticals USA, Inc. | $139 |
| IDORSIA PHARMACEUTICALS US INC | $70 |
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: 2013-10-03
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 |
|---|---|---|---|---|
| I20131003000599 | I | Nurse Practitioner | MO | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 63664)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| General Practice, Family Practice | MO | |
| C H I R O P R A C T I C | MO | |
| Pain Management, Anesthesiology, Anesthesiology, Pain Management | MO | |
| - | IA | |
| Internal Medicine | MO | |
| Nurse Practitioner | MO | |
| Clinical Social Worker | MO | |
| Internal Medicine, Critical Care (Intensivists), Pulmonary Disease | MO | |
| Orthopedic Surgery | MO | |
| Rheumatology, Internal Medicine | IL |
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