Doctor profile · Federal record
Dr. Dmitriy Stalivonenko, M.D.
Anesthesiology Physician (CMS: Anesthesiology) · Kenosha, WI
- NPI 1710966395
- Accepts Medicare
- 38 yrs in practice
- Male
- Group practice
- No sanctions
Practice & contact
Operates at 2 locations .
- Primary practice
-
10400 75Th St
Kenosha, WI 531427884
(414) 358-5443 - Additional location
-
3801 Spring St
Racine, WI 534051667
(262) 687-4011 - Mailing address
-
Po Box 735044
Chicago, IL 606735044
Credentials & registration
- NPI registered
- January 2006 — 20 yrs on file
- Profile last updated
- November 6, 2023
- Year of graduation
- 1988 — 38 yrs since
- Specialty taxonomy
- 207L00000X — NUCC code
- State license (1)
- Wisconsin #40879-020
- Medicaid
- WI #34055600
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1710966395. Last verified May 11, 2026.Medicare procedures · 2023
Top services delivered
Total services
15
Distinct HCPCS
1
Medicare allowed
$1,694
| HCPCS | Description | Services | Patients | Avg allowed | |
|---|---|---|---|---|---|
00142 |
Anesthesia for lens surgery | 15 | 15 | $113 |
In context: peer comparison
Among 5 peers in this city , average services per provider: 15. This provider delivers 1.0× the peer median.Hospital affiliations
Frequently asked questions
What is Dr. Dmitriy Stalivonenko's medical specialty?
Dr. Dmitriy Stalivonenko practices Anesthesiology Physician in Kenosha, WI.
Where does Dr. Dmitriy Stalivonenko practice?
Dr. Dmitriy Stalivonenko practices at 10400 75Th St, Kenosha, WI 531427884. Office phone: 4143585443.
What is Dr. Dmitriy Stalivonenko's NPI?
Dr. Dmitriy Stalivonenko's National Provider Identifier (NPI) is 1710966395, issued by NPPES.
Does Dr. Dmitriy Stalivonenko accept Medicare assignment?
Yes. Dr. Dmitriy Stalivonenko accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.
What procedures does Dr. Dmitriy Stalivonenko commonly perform?
Top Medicare-reported procedures in 2023: Anesthesia for lens surgery (HCPCS 00142). Source: CMS Medicare Physician & Other Practitioners file.