DR. MYRIAM JACYNTHE DONOVITCH M.D
NPI 1093332389
Family Medicine - Sports Medicine in Kenosha, WI

Q: What is Myriam Donovitch's NPI number?

The NPI number for Myriam Donovitch is 1093332389. It was assigned to this individual provider in the NPPES registry on July 2, 2020. The provider is also known as Dr. Myriam Jacynthe Benoit MD.

Q: What is Myriam Donovitch's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Q: When was this NPI record last updated?

The NPPES record for Myriam Donovitch was last updated on November 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 02, 2020PECOS EnrolledAccepts Medicare Assignment

7401 104TH AVE STE 110, KENOSHA, WI 53142(262) 764-5595 Get Directions Write a Review

NPPES record last updated: November 11, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 11, 2024, Jun 14, 2024, May 27, 2021 and 3 more (6 updates tracked since 2020).

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About Dr. Myriam Jacynthe Donovitch M.d NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MYRIAM JACYNTHE DONOVITCH M.D (NPI 1093332389) is an individual sports medicine provider in Kenosha, Wisconsin, licensed in Wisconsin (83968-20) and active in the NPI registry since July 2020. She is enrolled in Medicare PECOS, is affiliated with Froedtert South Inc., and maintains a secondary practice location in Minneapolis.

NPPES Registry Identity

NPI1093332389

Entity TypeIndividualFemale

Primary Taxonomy207QS0010X

Provider Legal NameDR. MYRIAM JACYNTHE DONOVITCHCredential: M.D

Location Address7401 104TH AVE STE 110Kenosha, WI 53142-7845

Mailing Address7401 104th Ave Ste 110Kenosha, WI 53142-7845 · (262) 764-5891

Phone(262) 764-5595

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateJuly 2, 2020

Last NPPES UpdateNovember 11, 20246 updates tracked since enumeration

NPPES CertifiedNovember 11, 2024

✔ NPI 1093332389 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QS0010X

License✔ Licensed in WI · 83968-20

Definition

A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.

7401 104TH AVE STE 110, Kenosha, WI 53142

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Other Names 1

Former Name (1)Dr. Myriam Jacynthe Benoit Md

Secondary Practice Location 1

Location 1420 Delaware St SEMinneapolis, MN 55455-0341 · Phone (612) 626-2338

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Network Health, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Myriam Jacynthe Donovitch M.d is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8224457429

PECOS Enrollment IDI20240709001859

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Myriam Donovitch reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Comprehensive Orthopaedics Sc

Same address

Orthopaedic Surgery

7401 104TH AVE, SUITE 110
Kenosha, WI 53142

Reassigned Medicare billing, Wisconsin enrollment
19 clinicians in this Medicare group

NPI 1295717445 (262) 764-5891

Iowa Physicians Clinic Medical Foundation

179 mi

General Practice

1518 MULBERRY AVENUE
Muscatine, IA 52761

Reassigned Medicare billing, Iowa enrollment
1,506 clinicians in this Medicare group

NPI 1982831426 (515) 471-9300

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

53 services39 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

15 services15 patients

X-ray of knee, 4 or more views 73564

An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.

12 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Froedtert South Inc.

Acute Care Hospitals · Pleasant Prairie, WI

1/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number520021

Location9555 76th StPleasant Prairie, WI 53158 · Kenosha County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53142 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CLAY JAMISON FRANK M.D.

Orthopaedic Surgery (Orthopaedic Surgery of the Spine)