SANDRA LEE MITKOS FNP
NPI 1790015527
Nurse Practitioner - Family in Potosi, MO
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
Specialties & Licenses
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
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.
Medicare Billing Reassignments
2Medicare enrollment records show Sandra Mitkos reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Potosi, MO 63664
- Reassigned Medicare billing, Missouri enrollment
- 60 clinicians in this Medicare group
Potosi, MO 63664
- Reassigned Medicare billing, Missouri enrollment
- 42 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.
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, MOPhysician 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.
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.
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.
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.
Which organizations bill Medicare for Sandra Mitkos's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Sandra Mitkos reassigns Medicare benefits to 2 organizations: Potosi Emergency Group, LLC (Potosi, MO) and Washington County Memorial Hospital (Potosi, MO). 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 Sandra Mitkos's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Sandra Mitkos accept?
Health plans from Anthem Blue Cross and Blue Shield list Sandra Mitkos 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 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 weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.
# Sandra Lee Mitkos, FNP · NPI 1790015527
Family physician in Potosi, Missouri. Individual provider, active in the CMS NPPES registry since December 29, 2009.
## Identity
- **NPI:** 1790015527 (Entity type: Individual)
- **Enumerated:** December 29, 2009
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 2009036279 (Missouri)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 108 FRIZZELL ST, Potosi, MO 63664-1505
- **Phone:** (573) 438-5408 · **Fax:** (573) 438-2419
## 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:** 2 organizations under Medicare reassignment (form CMS-855R): Potosi Emergency Group, LLC (NPI 1881075349, Potosi, MO); Washington County Memorial Hospital (NPI 1194838821, Potosi, MO) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2009
## Record status
- **NPPES last updated:** April 25, 2018
---
Source: [NPI Profile](https://npiprofile.com/npi/1790015527) · Data from the CMS NPPES public registry.