NPIMap

Individual provider Active NPI

Andrej Jivitski, MD

  • Anesthesiology Physician
  • Leesburg, FL
National Provider Identifier
1841286408
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME119527 Issued in FL
Practice address
700 Doctors CT
Leesburg, FL 34748-7314
Phone
(352) 787-9838
Fax
(352) 787-8705
NPI assigned
Sep 20, 2005
Last updated
Nov 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X C10006841 DE
Anesthesiology Physician 207L00000X MD28379 ME
Anesthesiology Physician 207L00000X 036168506 IL
Anesthesiology Physician 207L00000X ME119527 FL Primary

Addresses

Primary practice location

700 Doctors CT
Leesburg, FL 34748-7314

Mailing address

700 Doctors CT
Leesburg, FL 34748-7314
Phone (352) 867-8311

Other practice location 1

22 Bramhall St
Portland, ME 04102-3134
Phone (072) 662-2526

Other practice location 2

251 E Huron St Ste 5-704
Chicago, IL 60611-2908
Phone (312) 695-0061

Other identifiers 3

IdentifierTypeStateIssuer
014042100MedicaidFL
1841286408MedicaidME
14Z03OtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, ME, IL, MI4 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20150305001035 FL Practitioner - Anesthesiology 0941396329 Reassigns benefits to 3 organizations
I20240722002511 ME Practitioner - Anesthesiology 0941396329
I20241202001899 IL Practitioner - Anesthesiology 0941396329
I20260127003695 MI Practitioner - Anesthesiology 0941396329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560

100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C10006841DEMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stuart Cardiovascular Associates, PLLC CurrentSince Feb 1, 2015 Accepting new patients
Spectrum Health Primary Care Partners Current Accepting new patients
Spectrum Healthcare Partners, P.a. Anesthesiology CurrentSince Sep 1, 2024 Accepting new patients
Salem Health Current Accepting new patients
Spectrum Healthcare Partners, P.a. CurrentSince Sep 1, 2024 Accepting new patients
Citrus Cardiovascular Anesthesia Associates PLLC Anesthesiology CurrentSince Feb 1, 2015 Accepting new patients
Ocala Cardiovascular Anesthesia Associates PA Anesthesiology CurrentSince Feb 1, 2015 Accepting new patients
Spectrum Health Primary Care Partners Anesthesiology CurrentSince Dec 24, 2025 Accepting new patients
Mid Florida Cardiovascular Anesthesia Associates PA Anesthesiology CurrentSince Feb 1, 2015 Accepting new patients
Central Dupage Physician Group Past Accepting new patients
Pinnacle Mid-Atlantic Anesthesia Associates PC Anesthesiology PastSince Mar 7, 2011 Accepting new patients
Pinnacle Mid-Atlantic Pain Medicine, PC Anesthesiology Past Accepting new patients
Haverford Anesthesia Associates-NJ, P.C. Anesthesiology Past Accepting new patients

Locations

700 Doctors Ct
Leesburg, FL 34748
Phone (352) 787-9838

150 SE 17th St
Ste 503
Ocala, FL 34471
Phone (352) 433-2825

1500 SW 1st Ave
Ocala, FL 34471
Phone (352) 351-7500

524 SE Osceola St
#100
Stuart, FL 34994
Phone (772) 419-2379

35 Miles St
Damariscotta, ME 04543
Phone (207) 563-1234

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

324 Gannett Dr
Ste 200
South Portland, ME 04106
Phone (207) 482-7861

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

665 Winter St SE
Salem, OR 97301
Phone (503) 370-5634

890 Oak St SE
Salem, OR 97301
Phone (503) 585-0830

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 39

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

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1841286408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 DOCTORS CT",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487314",
            "telephone_number": "352-867-8311",
            "fax_number": "352-622-5771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 DOCTORS CT",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487314",
            "telephone_number": "352-787-9838",
            "fax_number": "352-787-8705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 Bramhall St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041023134",
            "country_code": "US",
            "telephone_number": "072-662-2526",
            "fax_number": "207-662-6236",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "251 E Huron St Ste 5-704",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112908",
            "country_code": "US",
            "telephone_number": "312-695-0061",
            "fax_number": "312-695-9013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIVITSKI",
        "first_name": "ANDREJ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "DE",
            "license": "C10006841",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "ME",
            "license": "MD28379",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036168506",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME119527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014042100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841286408",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "14Z03",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.