Mikhail Y Ivanovsky, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

E 3537 Issued in AR

Practice address

108 N Shackleford Rd
Little Rock, AR 72211-2840

Phone

(501) 712-2571

Fax

(501) 404-7789

NPI assigned

Jan 24, 2007

Last updated

Apr 5, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

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

Specialty

Pain ManagementAlso: Anesthesiology

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Pain Treatment Centers of America PLLCGroup PAC ID 2769608819, 73 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Pain Treatment Centers of America, PLLC

  • Multi-Specialty Clinic/Center
  • Little Rock, AR
  • NPI 1841619731
  Medicare reassignment Care Compare group NPD
• Pain Treatment Centers of America PLLC

  • Durable Medical Equipment & Medical Supplies
  • Harrison, AR
  • NPI 1821972225
  NPD
• Interventional Surgery Institute of Little Rock, LLC

  dba Interventional Surgery Institute

  • Ambulatory Surgical Clinic/Center
  • Little Rock, AR
  • NPI 1043625221
  NPD (past)
• Pain Treatment Centers of America, PLLC

  dba Family Care Centers of America

  • Family Medicine Physician
  • Rolling Fork, MS
  • NPI 1740946573
  NPD (past)

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1598810244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 N SHACKLEFORD RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722112840",
            "telephone_number": "501-712-2571",
            "fax_number": "501-404-7789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 N SHACKLEFORD RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722112840",
            "telephone_number": "501-712-2571",
            "fax_number": "501-404-7789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVANOVSKY",
        "first_name": "MIKHAIL",
        "middle_name": "Y",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AR",
            "license": "E 3537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marissa Israel
• Michael Israel, MD
• Avantika Gul Israni, MD
• Benjamin R Ittleman, M.D.
• Marina Ivanovsky, APN
• Samuil Ivanovsky
• Alaina Ivers
• Kendra Iverson, MHPP
• Laura Iverson
• Lisa Aurora Iverson, CPHT

• Anesthesiology Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Anesthesiology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; 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.