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SANDRA LEE MITKOS FNP
NPI 1790015527
Nurse Practitioner - Family in Potosi, MO

Active since December 29, 2009PECOS EnrolledAccepts Medicare Assignment
108 FRIZZELL ST, POTOSI, MO 63664(573) 438-5408(573) 438-2419 Get Directions Write a Review

NPPES record last updated: April 25, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Sandra Lee Mitkos Fnp NPPES

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

SANDRA LEE MITKOS FNP (NPI 1790015527) is an individual family provider in Potosi, Missouri, licensed in Missouri (2009036279) and active in the NPI registry since December 2009. She is enrolled in Medicare PECOS, is affiliated with Washington County Memorial Hospital, and is a graduate of Other (2009).

NPPES Registry Identity

NPI1790015527
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSANDRA LEE MITKOSCredential: FNP
Location Address108 FRIZZELL STPotosi, MO 63664-1505
Mailing Address300 Health Way DrPotosi, MO 63664-1420 · (573) 438-5451 · Fax (573) 438-2399
Phone(573) 438-5408
Fax(573) 438-2419
Sole ProprietorYes
Medical School CMSOtherGraduated 2009
Enumeration DateDecember 29, 2009
Last NPPES UpdateApril 25, 2018
✔ NPI 1790015527 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in MO · 2009036279
108 FRIZZELL ST, Potosi, MO 63664
Open in Google Maps ↗

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

Sandra Lee Mitkos Fnp 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 ID2264666304
PECOS Enrollment IDI20131003000599
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

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

Washington County Memorial Hospital

Critical Access Hospitals · Potosi, MO
OwnershipGovernment - Local
CMS Certification Number261308
Location300 Health WayPotosi, MO 63664 · Washington County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63664 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
$81.64 typical visit price
range $52.28 – $161.24
Typical copayment $20.41 (range $13.07 – $40.31)
Most-billed visit code 99203
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.

Referred Medical Equipment & Supplies CMS DME claims

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
2 suppliers14 claims30 services$5.71 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 4

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

DR. GARY LYNN GREENLEE JR. D.C.
Chiropractor
108 FRIZZELL ST
POTOSI, MO 63664
Washington County (573) 438-8500
PATRICIA LOUISE ALLEN APRN
Nurse Practitioner
108 FRIZZELL ST, SUITE 5
POTOSI, MO 63664
Washington County (573) 438-8500
DR. RUSTICO V SIMPELO MD
Family Medicine
108 FRIZZELL ST
POTOSI, MO 63664
Washington County (573) 438-5408
DR. STEVEN D EBERS MD
Family Medicine
108 FRIZZELL ST
POTOSI, MO 63664
Washington County (573) 438-8500

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 Sandra Mitkos's NPI number?

The NPI number for Sandra Mitkos is 1790015527. It was assigned to this individual provider in the NPPES registry on December 29, 2009.

Where is Sandra Mitkos located?

Sandra Mitkos practices at 108 Frizzell St, Potosi, MO 63664. The listed phone number is (573) 438-5408.

What is Sandra Mitkos's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Sandra Mitkos enrolled in Medicare?

Yes. Sandra Mitkos 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.

Is Sandra Mitkos affiliated with any hospitals?

According to CMS data, Sandra Mitkos is affiliated with Washington County Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Sandra Mitkos was last updated on April 25, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.