DONALD A MITZELFELT MD
NPI 1962454983
Orthopaedic Surgery in Pekin, IL

Active since May 17, 2006PECOS EnrolledAccepts Medicare Assignment
2351 BROADWAY ST, PEKIN, IL 61554(309) 353-4159(309) 353-4531 Get Directions Write a Review

NPPES record last updated: December 31, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Donald A Mitzelfelt Md NPPES

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

DONALD A MITZELFELT MD (NPI 1962454983) is an individual orthopaedic surgery provider in Pekin, Illinois, licensed in Illinois (036088541) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Proctor Hospital, and is a graduate of Loma Linda University School Of Medicine (1989).

NPPES Registry Identity

NPI1962454983
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameDONALD A MITZELFELTCredential: MD
Location Address2351 BROADWAY STPekin, IL 61554-3972
Mailing Address2351 Broadway StPekin, IL 61554-3972 · (309) 353-4159 · Fax (309) 353-4531
Fax(309) 353-4531
Sole ProprietorNo
Medical School CMSLoma Linda University School Of MedicineGraduated 1989
Enumeration DateMay 17, 2006
Last NPPES UpdateDecember 31, 2019
NPI 1962454983 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License Licensed in IL · 036088541
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
2351 BROADWAY ST, Pekin, IL 61554

Other Identifiers 3

OtherP00282243IL · Rail Road Medicare Pin
Medicaid036088541IL
Other09015685IL · Blue Cross Blue Shield

Accepted 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

Donald A Mitzelfelt Md 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 ID5799790713
PECOS Enrollment IDI20060213000658
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.

Areas of Expertise CMS Part B claims 29

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.

Hyaluronan or derivative, gelsyn-3, for intra-articular injection, 0.1 mg J7328
Gelsyn-3 is a treatment involving injections of a substance called hyaluronan into the joint space. Hyaluronan is naturally present in healthy joint fluid, aiding in lubrication and shock absorption. This treatment helps relieve joint pain, often in conditions like osteoarthritis.
39,840 services52 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
933 services362 patients
Injection, methylprednisolone acetate, 40 mg J1030
Methylprednisolone acetate is a medication given through an injection. It's a type of corticosteroid, which reduces inflammation and immune responses. It can be used to treat various conditions like arthritis, allergies, and skin diseases. This dose is 40 mg.
537 services146 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
421 services330 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
199 services199 patients
X-ray of knee, 4 or more views 73564
An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.
168 services167 patients

Hospital Affiliations CMS Care Compare 5

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

Proctor Hospital

Acute Care Hospitals · Peoria, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140013
Location5409 N Knoxville AvePeoria, IL 61614 · Peoria County
Emergency services

St Mary Medical Center

Acute Care Hospitals · Galesburg, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140064
Location3333 North SeminaryGalesburg, IL 61401 · Knox County
Emergency services Birthing friendly

Saint Francis Medical Center

Acute Care Hospitals · Peoria, IL
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140067
Location530 NE Glen Oak AvePeoria, IL 61637 · Peoria County
Emergency services Birthing friendly

Pekin Memorial Hospital

Acute Care Hospitals · Pekin, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140120
Location600 South 13th StreetPekin, IL 61554 · Tazewell County
Emergency services

Osf Saint Luke Medical Center

Critical Access Hospitals · Kewanee, IL
OwnershipVoluntary non-profit - Private
CMS Certification Number141325
Location1051 West South StreetKewanee, IL 61443 · Henry County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61554 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
Most-billed visit code 99213
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.

Reported Quality Measures

Closing the Referral Loop: Receipt of Specialist Report
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred
71%65 patients4/55-star benchmark: 95%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
97%3,033 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
83%118 patients3/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
98%529 patients4/55-star benchmark: 99%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
92%92 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
86%443 patients4/55-star benchmark: 99%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
52%471 patients3/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
83%1,187 patients4/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
53%491 patients3/55-star benchmark: 88%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 98% · 513 patients
Patients tobacco: 91% · 513 patients
49%72 patients3/55-star benchmark: 98%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
58%443 patients3/55-star benchmark: 100%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 529 patients
2%529 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

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

Knee orthosis, elastic with joints, prefabricated, off-the-shelf L1812
DME-Orthotic Devices · category DF011N
1 supplier23 claims23 services$67.45 avg. paid by Medicare
Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf L3660
DME-Orthotic Devices · category DF000N
1 supplier11 claims11 services$78.21 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 14

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

Physical Therapist
2351 BROADWAY ST
PEKIN, IL 61554
Physician Assistant (Surgical)
2351 BROADWAY ST
PEKIN, IL 61554
Podiatrist (Foot & Ankle Surgery)
2351 BROADWAY ST
PEKIN, IL 61554
Speech-Language Pathologist
2351 BROADWAY ST
PEKIN, IL 61554
Occupational Therapy Assistant
2351 BROADWAY ST
PEKIN, IL 61554
Physician Assistant
2351 BROADWAY ST
PEKIN, IL 61554
Physical Therapy Assistant
2351 BROADWAY ST
PEKIN, IL 61554
Physical Therapy Assistant
2351 BROADWAY ST
PEKIN, IL 61554

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 Donald Mitzelfelt's NPI number?

The NPI number for Donald Mitzelfelt is 1962454983. It was assigned to this individual provider in the NPPES registry on May 17, 2006.

Where is Donald Mitzelfelt located?

Donald Mitzelfelt practices at 2351 Broadway St, Pekin, IL 61554. The listed phone number is (309) 353-4159.

What is Donald Mitzelfelt's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Donald Mitzelfelt enrolled in Medicare?

Yes. Donald Mitzelfelt 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 Donald Mitzelfelt accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Donald Mitzelfelt 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 Donald Mitzelfelt affiliated with any hospitals?

According to CMS data, Donald Mitzelfelt is affiliated with Proctor Hospital, St Mary Medical Center, Saint Francis Medical Center, Pekin Memorial Hospital and Osf Saint Luke Medical Center.

When was this NPI record last updated?

The NPPES record for Donald Mitzelfelt was last updated on December 31, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.