DR. VASILISA MIRONOVICH M.D.
NPI 1295024479
Family Medicine in Portage, WI

Q: What is Vasilisa Mironovich's NPI number?

The NPI number for Vasilisa Mironovich is 1295024479. It was assigned to this individual provider in the NPPES registry on March 28, 2011.

Q: What is Vasilisa Mironovich's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since March 28, 2011PECOS EnrolledAccepts Medicare Assignment

86.87/100

CMS Quality Rating

2817 NEW PINERY RD, PORTAGE, WI 53901(608) 742-4131(608) 745-6393 Get Directions Write a Review

NPPES record last updated: September 2, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Vasilisa Mironovich M.d. NPPES

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

DR. VASILISA MIRONOVICH M.D. (NPI 1295024479) is an individual family medicine provider in Portage, Wisconsin, licensed in Wisconsin (60837-20) and active in the NPI registry since March 2011. She is enrolled in Medicare PECOS, is affiliated with Divine Savior Healthcare, and is a graduate of Other (2010).

NPPES Registry Identity

NPI1295024479

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameDR. VASILISA MIRONOVICHCredential: M.D.

Location Address2817 NEW PINERY RDPortage, WI 53901-9240

Mailing Address2817 New Pinery RdPortage, WI 53901-9240 · (608) 742-4131 · Fax (608) 745-6393

Phone(608) 742-4131

Fax(608) 745-6393

Sole ProprietorNo

Medical School CMSOtherGraduated 2010

Enumeration DateMarch 28, 2011

Last NPPES UpdateSeptember 2, 2014

✔ NPI 1295024479 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in WI · 60837-20

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

2817 NEW PINERY RD, Portage, WI 53901

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, Group Health Cooperative-SCW and more.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. Vasilisa Mironovich 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 ID5294956157

PECOS Enrollment IDI20141020000665

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.

Hospital Affiliations CMS Care Compare 2

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

Divine Savior Healthcare

Acute Care Hospitals · Portage, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520041

Location2817 New Pinery RoadPortage, WI 53901 · Columbia County

Emergency services

University Of Wi Hospitals & Clinics Authority

Acute Care Hospitals · Madison, WI

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number520098

Location600 Highland AvenueMadison, WI 53792 · Dane County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53901 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.

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.

86.87/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

89.05

Promoting Interoperability

100

Improvement Activities

Cost

63.39

Referred Medical Equipment & Supplies CMS DME claims 9

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

8 suppliers20 claims51 services$5.60 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

6 suppliers13 claims18 services$1.02 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

4 suppliers11 claims11 services$42.69 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

3 suppliers17 claims84 services$1.92 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

2 suppliers17 claims17 services$16.31 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

3 suppliers19 claims19 services$51.24 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

BRITTANY LEIGH READ CCC-SLP

Speech-Language Pathologist

2817 NEW PINERY RD
PORTAGE, WI 53901

Columbia County (608) 742-4131

ELIZABETH SHARRON REDDEMAN DPT

Physical Therapist

2817 NEW PINERY RD
PORTAGE, WI 53901

Columbia County (608) 745-6290

MRS. BONNIE SUE STANISLAWSKI AU. D.

Audiologist-Hearing Aid Fitter

2817 NEW PINERY RD, SUITE 103
PORTAGE, WI 53901

Columbia County (608) 745-6290

MADISON LEE PHARMD

Pharmacist

2817 NEW PINERY RD
PORTAGE, WI 53901

Columbia County (608) 742-4131

DEBORAH BRZYCKI CRNA

Nurse Anesthetist, Certified Registered

2817 NEW PINERY RD
PORTAGE, WI 53901

Columbia County (262) 416-8317

TERRA THIMM

Emergency Medicine

2817 NEW PINERY RD
PORTAGE, WI 53901

Columbia County (608) 742-4131

DILLON VIA

Physician Assistant

2817 NEW PINERY RD
PORTAGE, WI 53901

Columbia County (608) 742-4131

MICHAEL C WALTERS MD

Emergency Medicine

2817 NEW PINERY RD
PORTAGE, WI 53901

Columbia County (608) 745-5689

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 Vasilisa Mironovich's NPI number?

The NPI number for Vasilisa Mironovich is 1295024479. It was assigned to this individual provider in the NPPES registry on March 28, 2011.

Where is Vasilisa Mironovich located?

Vasilisa Mironovich practices at 2817 New Pinery Rd, Portage, WI 53901. The listed phone number is (608) 742-4131.

What is Vasilisa Mironovich's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Vasilisa Mironovich enrolled in Medicare?

Yes. Vasilisa Mironovich 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 Vasilisa Mironovich accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, Group Health Cooperative-SCW, HealthPartners and Quartz and 1 other insurer list Vasilisa Mironovich 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.

Is Vasilisa Mironovich affiliated with any hospitals?

According to CMS data, Vasilisa Mironovich is affiliated with Divine Savior Healthcare and University Of Wi Hospitals & Clinics Authority.

When was this NPI record last updated?

The NPPES record for Vasilisa Mironovich was last updated on September 2, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.