Dmitriy Stalivonenko, M.D.
NPI 1710966395 · Anesthesiology Physician · Kenosha, WI
Enrolled with Medicare as Practitioner - Anesthesiology · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Dmitriy Stalivonenko, M.D. is a Anesthesiology Physician provider in Kenosha, WI (NPI 1710966395).
Provider details
- NPI number
- 1710966395
- Entity type
- Individual
- Primary specialty
- Anesthesiology PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 40879-020 (WI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 3801 Spring StRacine, WI 53405-1667Phone: (262) 687-4011
Registry dates
- Enumerated
- 2006-01-12
- Last updated
- 2023-11-06
- Certified
- 2023-11-06
Frequently asked questions
- What is Dmitriy Stalivonenko's NPI number?
- Dmitriy Stalivonenko's National Provider Identifier (NPI) is 1710966395, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Dmitriy Stalivonenko's specialty?
- Dmitriy Stalivonenko is listed in the NPPES registry with a primary specialty of Anesthesiology Physician (Allopathic & Osteopathic Physicians).
- Where is Dmitriy Stalivonenko located?
- Dmitriy Stalivonenko's practice location on file with NPPES is 10400 75th St, Kenosha, WI 53142-7884.
- What is Dmitriy Stalivonenko's phone number?
- The practice phone number listed in the NPPES registry for Dmitriy Stalivonenko is (414) 358-5443.
- Does Dmitriy Stalivonenko accept Medicare?
- Dmitriy Stalivonenko is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Dmitriy Stalivonenko's NPI active?
- Yes — Dmitriy Stalivonenko's NPI (1710966395) is active in the NPPES registry as of the last update on 2023-11-06.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.