DR. MICHAEL MSTISLAVOVICH IVANITSKY (MD) – Orthopaedic Surgery Physician, NPI 1003837410
Orthopaedic Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
383 ORTHOPEDIC SURGERY in OR
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Provider Addresses for DR. MICHAEL MSTISLAVOVICH IVANITSKY (MD)
Coquille Valley Hospital, 940, East 5th Street, Coquille, Coos County, Oregon, 97423, United States
COQUILLE, OR 974231699
Phone: (541) 396-3111
Fax: (541) 396-8135
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 16 Open Payments records for all available years, with a total value of $1,994.
Total Amount is formed as General ($1,994) + Research ($0) + Ownership ($0) = $1,994.
Last reported payment date: 2024-11-13 • Largest payer in this snapshot: Smith+Nephew, Inc. ($1,754).
Total Amount
$1,994
General + Research + Ownership
Payments
16
Total payment records
General Amount
$1,994
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Smith+Nephew, Inc. | $1,754 |
| Arthrex, Inc. | $154 |
| Heron Therapeutics, Inc. | $53 |
| STEELHEAD SURGICAL INC | $34 |
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: 2008-05-08
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 |
|---|---|---|---|---|
| I20080508000761 | I | Orthopedic Surgery | OR | 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 97423)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Social Worker | WA | |
| Emergency Medicine | PA | |
| Emergency Medicine | NY | |
| Nurse Practitioner | OR | |
| Physician Assistant | OR | |
| - | OR | |
| - | OR | |
| Emergency Medicine | OH | |
| Clinical Social Worker | WA | |
| Emergency Medicine | FL |
Reviews
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