Individual provider Active NPI

Dmitriy R Sintsov, MD

  • Anesthesiology Physician
  • Evansville, IN
National Provider Identifier
1538267281
Registry record updated Feb 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
61870 Issued in MN
Practice address
600 Mary Street
Evansville, IN 47747-2195
Phone
(812) 450-2240
Fax
(812) 450-2710
NPI assigned
Sep 20, 2006
Last updated
Feb 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 01067281A IN
Anesthesiology Physician 207L00000X 9526 ND
Anesthesiology Physician 207L00000X 61870 MN Primary

Addresses

Primary practice location

600 Mary Street
Evansville, IN 47747-2195

Mailing address

PO Box 5545
Lafayette, IN 47903-5545
Phone (765) 448-8000

Other practice location 1

3001 Broadway St NE # 150
Minneapolis, MN 55413-2195
Phone (612) 871-1145

Other identifiers 2

IdentifierTypeStateIssuer
200974210MedicaidIN
000000639273OtherINANTHEM PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20091121000092 IN Practitioner - Anesthesiology 6204815699 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deaconess Hospital, Inc.Group PAC ID 9032021431, 410 clinicians

Practice addresses (Care Compare)

600 Mary St
Evansville, IN 47710-1658
Phone (812) 450-7299

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.17 of 100Reported as group
Quality
82.57
Promoting interoperability
100
Improvement activities
40
Cost
71.91

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01067281AINMDAnesthesiology Physician
61870MNMDAnesthesiology Physician
9526NDMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Hospital, Inc Current Accepting new patients
Deaconess Hospital Inc CurrentSince Oct 1, 2019 Accepting new patients
Deaconess Hospital, Inc Anesthesiology CurrentSince Oct 1, 2019 Accepting new patients
Saginaw Anesthesia Services, PLLC Anesthesiology Past Accepting new patients
Affiliated Endoscopy Centers, LLC PastSince Jan 8, 2018 Accepting new patients
Mngi Endoscopy ASC Inc PastSince Apr 2, 2018 Accepting new patients

Locations

600 Mary St
Evansville, IN 47710
Phone (812) 450-2239

4011 Gateway Blvd
Newburgh, IN 47630
Phone (812) 450-2240

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 6

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

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1538267281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5545",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479035545",
            "telephone_number": "765-448-8000",
            "fax_number": "765-448-8085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MARY STREET",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477472195",
            "telephone_number": "812-450-2240",
            "fax_number": "812-450-2710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3001 Broadway St NE # 150",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554132195",
            "country_code": "US",
            "telephone_number": "612-871-1145",
            "fax_number": "612-870-5491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SINTSOV",
        "first_name": "DMITRIY",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01067281A",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "ND",
            "license": "9526",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MN",
            "license": "61870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200974210",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000639273",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.