DR. DMITRY FAMILTSEV M.D., PH.D.
NPI 1194161174
Internal Medicine - Interventional Cardiology in Rolla, MO

Active since May 16, 2013PECOS EnrolledAccepts Medicare Assignment
78.73/100
CMS Quality Rating
1050 W 10TH ST, ROLLA, MO 65401(573) 308-1301(573) 202-2480 Get Directions Write a Review

NPPES record last updated: March 24, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 24, 2021, Aug 21, 2019, May 15, 2019 and 2 more (5 updates tracked since 2017).

About Dr. Dmitry Familtsev M.d., Ph.d. NPPES

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

DR. DMITRY FAMILTSEV M.D., PH.D. (NPI 1194161174) is an individual interventional cardiology provider in Rolla, Missouri, licensed in Missouri (2018013507) and active in the NPI registry since May 2013. He is enrolled in Medicare PECOS, maintains a secondary practice location in Tucson, and is a graduate of Other (2008).

NPPES Registry Identity

NPI1194161174
Entity TypeIndividualMale
Primary Taxonomy207RI0011X
Provider Legal NameDR. DMITRY FAMILTSEVCredential: M.D., PH.D.
Location Address1050 W 10TH STRolla, MO 65401-2905
Mailing Address1050 W 10th StRolla, MO 65401-2905 · (573) 426-2182 · Fax (573) 426-5341
Fax(573) 202-2480
Sole ProprietorNo
Medical School CMSOtherGraduated 2008
Enumeration DateMay 16, 2013
Last NPPES UpdateMarch 24, 20215 updates tracked since enumeration
NPPES CertifiedMarch 23, 2021
NPI 1194161174 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyInternal Medicine · Interventional CardiologyAllopathic & Osteopathic Physicians
Taxonomy Code207RI0011X
License Licensed in MO · 2018013507
Definition
An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system.
Also ListedInternal Medicine · Cardiovascular DiseaseTaxonomy 207RC0000X · License 2018013507 (MO)
1050 W 10TH ST, Rolla, MO 65401

Secondary Practice Location 1

Location 11501 N Campbell AveTucson, AZ 85724-0001 · Phone (520) 626-1416 · Fax (520) 626-4333

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Dmitry Familtsev M.d., Ph.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 ID2466752050
PECOS Enrollment IDI20231117001482
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.

Areas of Expertise CMS Part B claims 20

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.

Injection, regadenoson, 0.1 mg J2785
Regadenoson injection, 0.1 mg, is a medication used to help visualize the heart during a stress test. It works by increasing blood flow in the arteries of the heart. It's injected into a vein and is generally well-tolerated.
129 services33 patients
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306
This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
125 services124 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
109 services80 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
94 services86 patients
Technetium tc-99m sestamibi, diagnostic, per study dose A9500
Technetium Tc-99m Sestamibi is a diagnostic test used to create images of your heart or breast tissues. It involves a safe radioactive substance injection that helps doctors to detect any abnormalities or changes in these tissues.
87 services44 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
79 services55 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 65401 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
$121.96 typical visit price
range $52.28 – $161.24
Typical copayment $30.49 (range $13.07 – $40.31)
Most-billed visit code 99204
Established Patient
$93.24 typical visit price
range $16.30 – $131.05
Typical copayment $23.31 (range $4.07 – $32.76)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

78.73/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality68.21
Promoting Interoperability100
Improvement Activities40
Cost51.37

Other Providers at the Same Location NPPES 20

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

Pediatrics
1050 W 10TH ST
ROLLA, MO 65401
Internal Medicine
1050 W 10TH ST
ROLLA, MO 65401
Internal Medicine
1050 W 10TH ST
ROLLA, MO 65401
Orthopaedic Surgery
1050 W 10TH ST
ROLLA, MO 65401
Obstetrics & Gynecology
1050 W 10TH ST
ROLLA, MO 65401
Psychiatry & Neurology (Neurology)
1050 W 10TH ST
ROLLA, MO 65401
Nurse Practitioner (Adult Health)
1050 W 10TH ST
ROLLA, MO 65401
Physician Assistant
1050 W 10TH ST
ROLLA, MO 65401

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dmitry Familtsev's NPI number?

The NPI number for Dmitry Familtsev is 1194161174. It was assigned to this individual provider in the NPPES registry on May 16, 2013.

Where is Dmitry Familtsev located?

Dmitry Familtsev practices at 1050 W 10th St, Rolla, MO 65401. The listed phone number is (573) 308-1301.

What is Dmitry Familtsev's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Interventional Cardiology, with taxonomy code 207RI0011X.

Is Dmitry Familtsev enrolled in Medicare?

Yes. Dmitry Familtsev is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Dmitry Familtsev accept?

Health plans from Ambetter from Arizona Complete Health, Antidote Health Plan of Arizona, Inc., Blue Cross Blue Shield of Arizona, Imperial Insurance Companies, Inc. and Oscar Health Plan, Inc. and 1 other insurer list Dmitry Familtsev as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Dmitry Familtsev was last updated on March 24, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.