SERGE MISTIVAR D.O
NPI 1609080126
Family Medicine in Immokalee, FL

Q: What is Serge Mistivar's NPI number?

The NPI number for Serge Mistivar is 1609080126. It was assigned to this individual provider in the NPPES registry on May 10, 2007.

Q: What is Serge Mistivar's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Serge Mistivar was last updated on January 7, 2015. 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.

Active since May 10, 2007PECOS Enrolled

1454 MADISON AVE W, IMMOKALEE, FL 34142(239) 658-3064(239) 658-3175 Get Directions Write a Review

NPPES record last updated: January 7, 2015. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Serge Mistivar D.o NPPES

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

SERGE MISTIVAR D.O (NPI 1609080126) is an individual family medicine provider in Immokalee, Florida, licensed in Georgia (064865) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1609080126

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameSERGE MISTIVARCredential: D.O

Location Address1454 MADISON AVE WImmokalee, FL 34142-2200

Mailing Address1454 Madison Ave WImmokalee, FL 34142-2200 · (239) 658-3064 · Fax (239) 658-3175

Phone(239) 658-3064

Fax(239) 658-3175

Sole ProprietorNo

Enumeration DateMay 10, 2007

Last NPPES UpdateJanuary 7, 2015

✔ NPI 1609080126 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in GA · 064865

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.

1454 MADISON AVE W, Immokalee, FL 34142

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Other Identifiers 4

Medicare PINAG277YFL

OtherOS 9898FL · Medical License

Other064865GA · Physician License

OtherDO.1242AL · Alabama

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Serge Mistivar D.o is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignment

Medicare enrollment records show Serge Mistivar reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Department Of State Hospitals

2,125 mi

Psychiatric Hospital

3102 E HIGHLAND AVE
Patton, CA 92369

Reassigned Medicare billing, California enrollment
755 clinicians in this Medicare group

NPI 1043249204 (909) 425-7552

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 34142 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

$91.69 typical visit price

range $58.56 – $179.05

Typical copayment $22.92 (range $14.64 – $44.76)

Most-billed visit code 99203

Established Patient

$103.21 typical visit price

range $18.44 – $144.68

Typical copayment $25.80 (range $4.61 – $36.17)

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 20

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

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