Myriam Jacynthe Donovitch, M.D

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

83968-20 Issued in WI

Practice address

7401 104TH Ave Ste 110
Kenosha, WI 53142-7845

Phone

(262) 764-5595

NPI assigned

Jul 2, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Dr. Myriam Jacynthe Benoit Former name

Medicare fee-for-service enrollment

Enrolled in IA, WI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Sports Medicine

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advantage Physical Therapy and Sports Rehab, LLCGroup PAC ID 8022016336, shared by 3 NPIs, 289 clinicians

Comprehensive Orthopaedics SCGroup PAC ID 3375445497, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Froedtert South Inc. Hospital, Kenosha, WI, CCN 520021

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: myriam.donovitch.p1@direct.comportho.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Comprehensive Orthopaedics SC

  • Orthopaedic Surgery Physician
  • Kenosha, WI
  • NPI 1295717445

  Sports Medicine

  Medicare reassignment Care Compare group NPD
• Iowa Physicians Clinic Medical Foundation

  dba UnityPoint Clinic

  • General Practice Physician
  • West Des Moines, IA
  • NPI 1366425274

  Family Medicine

  Medicare reassignment NPD
• Comprehensive Orthopaedics SC

  dba Comprehensive Orthopaedics Advanced Imaging and Rehab Center

  • Physical Therapy Clinic/Center
  • Kenosha, WI
  • NPI 1194611939
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Froedtert South, Inc.

  • General Acute Care Hospital
  • Pleasant Prairie, WI
  • NPI 1003831132
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1593648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1093332389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7401 104TH AVE STE 110",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531427845",
            "telephone_number": "262-764-5891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7401 104TH AVE STE 110",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531427845",
            "telephone_number": "262-764-5595"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 Delaware St SE",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554550341",
            "country_code": "US",
            "telephone_number": "612-626-2338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONOVITCH",
        "first_name": "MYRIAM",
        "middle_name": "JACYNTHE",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-02",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "WI",
            "license": "83968-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MYRIAM",
            "last_name": "BENOIT",
            "middle_name": "JACYNTHE",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Andrea Domina, PT
• Kathleen Donkor, RN
• Donlee Health and Wellness LLC
• Edward J Donner, PH.D.
• Peyton Donofrio, RDN
• Jyron Donson
• Jessica L Dorner, LPC
• Sarah Ann Dosemagen, PTA
• Cina Zsonvielle Douglas, PTA
• Angela Marie Downs, LPC-IT

• Sports Medicine (Family Medicine) Physician in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Sports Medicine (Family Medicine) Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.