ERIC A KIVISTO DO
NPI 1447257316
Surgery in Mendota, IL
About Eric A Kivisto Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ERIC A KIVISTO DO (NPI 1447257316) is an individual surgery provider in Mendota, Illinois, licensed in Illinois (036091073) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS, maintains a secondary practice location in Herrin, and is a graduate of Chicago College Of Osteopathy (1989).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Other Identifiers 3
Accepted 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
Eric A Kivisto Do 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.
Medicare Billing Reassignments
3Medicare enrollment records show Eric Kivisto reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Mendota, IL 61342
- Reassigned Medicare billing, Illinois enrollment
- 95 clinicians in this Medicare group
Carbondale, IL 62901
- Reassigned Medicare billing, Illinois enrollment
- 702 clinicians in this Medicare group
Sturgis, KY 42459
- Reassigned Medicare billing, Kentucky enrollment
- 28 clinicians in this Medicare group
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
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 61342 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 8
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Eric Kivisto's NPI number?
The NPI number for Eric Kivisto is 1447257316. It was assigned to this individual provider in the NPPES registry on July 6, 2005.
Where is Eric Kivisto located?
Eric Kivisto practices at 1405 E 12th St Suite 500, Mendota, IL 61342. The listed phone number is (815) 539-1789.
What is Eric Kivisto's specialty?
The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.
Is Eric Kivisto enrolled in Medicare?
Yes. Eric Kivisto 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.
Which organizations bill Medicare for Eric Kivisto's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Eric Kivisto reassigns Medicare benefits to 3 organizations: Mendota Community Hospital (Mendota, IL), Southern Illinois Medical Services, Nfp (Carbondale, IL) and Crittenden Community Hospital LLC (Sturgis, KY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Eric Kivisto's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Eric Kivisto accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter of Tennessee and Anthem Blue Cross and Blue Shield list Eric Kivisto 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 Eric Kivisto was last updated on December 7, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Eric A Kivisto, DO · NPI 1447257316
Surgery physician in Mendota, Illinois. Individual provider, active in the CMS NPPES registry since July 6, 2005.
## Identity
- **NPI:** 1447257316 (Entity type: Individual)
- **Enumerated:** July 6, 2005
- **Primary specialty:** Surgery · taxonomy 208600000X
- **State license:** 036091073 (Illinois)
- **Sole proprietor:** No
## Practice location
- **Address:** 1405 E 12TH ST, SUITE 500, Mendota, IL 61342-9010
- **Phone:** (815) 539-1789 · **Fax:** (815) 539-1430
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Mendota Community Hospital (NPI 1407872997, Mendota, IL); Southern Illinois Medical Services, Nfp (NPI 1770656837, Carbondale, IL); Crittenden Community Hospital LLC (NPI 1013727882, Sturgis, KY) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Chicago College Of Osteopathy, class of 1989
## Record status
- **NPPES last updated:** December 7, 2022
- **Other identifiers:** Other 371342699 (IL); Medicaid 036091073 (IL); Other 02706617 (IL)
---
Source: [NPI Profile](https://npiprofile.com/npi/1447257316) · Data from the CMS NPPES public registry.