ILYA A KHOTIMSKY (M.D.) – Anesthesiology Physician, NPI 1245563329

ILYA A KHOTIMSKY (M.D.) is a healthcare provider. based in Fond du lac, Wisconsin. specializing in ANESTHESIOLOGY. They hold the professional credentials M.D.. They hold a License No. 56854-20 (WI). The NPI Number for ILYA A KHOTIMSKY (M.D.) is 1245563329

Main info

Male
27 Years Of Experience
Accepts Medicare Assignment
Name
ILYA A KHOTIMSKY (M.D.)
NPI
1245563329
Phone
(920) 929-2300
Address
430 E DIVISION ST
Enumeration Date
8 September 2009
Last Update Date
30 December 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2625778000
Graduation Year
1999 (27 years ago)
PAC ID
9032333414
Group Practice PAC ID
2163968819
Professional Enrollment ID
I20140605001530
Address ID
WI531581984PL9555XSTXX300

Contacts

Secure Messaging
ikhotimski57464@direct.ascension.org
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience65
Completeness85
Years active:16State licenses:2Other namesUpdated within 12 months

1,267 ANESTHESIOLOGY in WI

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Provider Addresses for ILYA A KHOTIMSKY (M.D.)

  • Fond-du-Lac, Northern Saskatchewan Administration District, Saskatchewan, Canada

    FOND DU LAC, WI 549354560

    Phone: (920) 929-2300

    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)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2014-06-05

PECOS data refreshed: 2026-06-15

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20140605001530IAnesthesiologyWITBD

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
00142Anesthesia for lens surgery2121$0
76937Ultrasonic guidance for blood vessel access1818$0
36620Insertion of artery tube for blood sampling or infusion through skin1515$0
View full utilization report →

Insurance plans in this area (ZIP 54935)

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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: 2163968819View full group profile
NameSpecialtyState
A N E S T H E S I O L O G YIL
A N E S T H E S I O L O G YWI
A N E S T H E S I O L O G YWI
A N E S T H E S I O L O G YIL
A N E S T H E S I O L O G YCA
A N E S T H E S I O L O G YWI
A N E S T H E S I O L O G YIL
A N E S T H E S I O L O G YIL
A N E S T H E S I O L O G YCO
A N E S T H E S I O L O G YIL

Reviews

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Frequently asked questions

How is ILYA A KHOTIMSKY (M.D.) identified in CMS data?
CMS-hosted NPPES data lists ILYA A KHOTIMSKY (M.D.) with NPI 1245563329.
Does the file indicate ILYA A KHOTIMSKY (M.D.) is practicing under active NPI?
Directory data currently reports ILYA A KHOTIMSKY (M.D.) as active.
What taxonomy line describes ILYA A KHOTIMSKY (M.D.)?
For research purposes, treat ILYA A KHOTIMSKY (M.D.) as Anesthesiology Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect ILYA A KHOTIMSKY (M.D.) on a map?
Expect Fond Du Lac, Wisconsin as a primary anchor for ILYA A KHOTIMSKY (M.D.) unless the record lists multiple sites.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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