Serge Mistivar, DO - Medicare Family Medicine in Immokalee, FL

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Serge Mistivar, DO is a medicare enrolled "Family Medicine" physician in Immokalee, Florida. His current practice location is 1454 Madison Ave W, Immokalee, Florida. You can reach out to his office (for appointments etc.) via phone at (239) 658-3064.

Serge Mistivar is licensed to practice in Georgia (license number 064865) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1609080126.

Contact Information

Serge Mistivar, DO
1454 Madison Ave W,
Immokalee, FL 34142-2200
(239) 658-3064
(239) 658-3175

Map and Direction




Physician's Profile

Full NameSerge Mistivar
GenderMale
SpecialityFamily Medicine
Location1454 Madison Ave W, Immokalee, Florida
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1609080126
  • Provider Enumeration Date: 05/10/2007
  • Last Update Date: 01/07/2015
  Medicare PECOS Information:
  • PECOS PAC ID: 9931294238
  • Enrollment ID: I20210217002337

Medical Identifiers

Medical identifiers for Serge Mistivar such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1609080126NPI-NPPES
064865OtherGAPHYSICIAN LICENSE
DO.1242OtherALALABAMA
OS 9898OtherFLMEDICAL LICENSE

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine 064865 (Georgia)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Serge Mistivar allows following entities to bill medicare on his behalf.
Entity NameDepartment Of State Hospitals
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1124078704
PECOS PAC ID: 9638174238
Enrollment ID: O20081031000305

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Serge Mistivar is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Serge Mistivar, DO
1454 Madison Ave W,
Immokalee, FL 34142-2200

Ph: (239) 658-3064		Serge Mistivar, DO
1454 Madison Ave W,
Immokalee, FL 34142-2200

Ph: (239) 658-3064

Reviews and Comments


Family Medicine Doctors in Immokalee, FL

Dr. Jaimenee Khemraj, M.D.
Family Medicine
Medicare: Medicare Enrolled
Practice Location: 1454 Madison Ave W, Immokalee, FL 34142
Phone: 239-658-3000    
Kristen Lena Dimas, MD
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1454 Madison Ave W, Immokalee, FL 34142
Phone: 239-658-3000    
Mr. Reinier F Ramirez, MD
Family Medicine
Medicare: May Accept Medicare Assignments
Practice Location: 1454 Madison Ave W, Immokalee, FL 34142
Phone: 239-658-3064    Fax: 239-658-3175
Joseph James Guernsey,
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1454 Madison Ave W, Immokalee, FL 34142
Phone: 239-658-3000    
Claudia Teresa Lenis, M.D.
Family Medicine
Medicare: Medicare Enrolled
Practice Location: 1454 Madison Ave W, Immokalee, FL 34142
Phone: 239-658-3000    Fax: 239-658-3175
Marlene Gonzalez, M.D.
Family Medicine
Medicare: May Accept Medicare Assignments
Practice Location: 1454 Madison Ave W, Immokalee, FL 34142
Phone: 239-658-3000    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.