Active NPI 1447257316 Individual Practitioner Male Practitioner

Dr. Eric A Kivisto , DO

Surgery • Mendota, IL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Eric Kivisto, DO is a certified Surgery practicing in Mendota, IL. With approximately 37 years of clinical experience since graduating from Chicago College Of Osteopathy in 1989, Dr. Kivisto delivers high-quality medical care to the local community at 1405 E 12TH ST.

Dr. Kivisto is affiliated with Crittenden Community Hospital Llc and accepts Medicare assignment.

Frequently performed procedures and clinical services include biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope, subsequent hospital care with moderate levelof medical decision making, if using time, at least, initial hospital care with straightforward or low-level medical decision making, if using time, at least. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1405 E 12th St
Suite 500

Mendota, IL 613429010

Telephone 8155391789

Fax 8155391430

Associated Practice Facility / Clinic

🏢 Associated Physicians, Sc Facility NPI 1265562151

Medicare Profile & Education

Medical School

Chicago College Of Osteopathy

Graduation Year

1989

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Mendota, IL

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

37 Yrs Matches City Avg

City Avg: 37.0 Yrs

State Avg: 27.3 Yrs

Regional Practice Density

2 Specialists

Practicing in Mendota, IL (1624 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

59.5% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Kivisto (37 Years) 37 Yrs

Mendota Specialty Average (37.0 Years) 37.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	22	18	$265.00	$107.29

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	53	32	$117.13	$77.28
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	41	39	$219.05	$127.24
99231 Follow-up hospital inpatient care per day, typically 15 minutes	34	24	$84.18	$48.87
99221 Initial hospital inpatient care per day, typically 30 minutes	12	12	$159.00	$81.81

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	125	100	$267.92	$124.25
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	85	85	$392.85	$163.75
99213 Established patient office or other outpatient visit, typically 15 minutes	75	62	$191.20	$86.12
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	56	51	$1943.29	$102.40
45380 Biopsy of large bowel using an endoscope	24	23	$2264.75	$189.62
45378 Diagnostic exam of large bowel using a flexible endoscope	22	22	$1706.32	$176.98
45384 Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery	20	20	$2535.65	$228.77
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	16	16	$2353.75	$251.45
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	13	13	$262.92	$109.42
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	13	13	$1744.31	$182.94
99221 Initial hospital inpatient care per day, typically 30 minutes	11	11	$273.00	$98.35
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	11	11	$1765.45	$181.75

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	213	146	$266.00	$126.46
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	132	132	$387.14	$165.13
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	80	72	$1818.75	$103.28
99213 Established patient office or other outpatient visit, typically 15 minutes	52	45	$175.92	$89.26
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	42	20	$187.76	$70.76
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	39	38	$358.21	$134.10
45384 Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery	36	36	$2309.29	$229.07
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	28	28	$2180.21	$254.01
45378 Diagnostic exam of large bowel using a flexible endoscope	23	23	$1560.78	$185.71
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	18	18	$1539.61	$178.37

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	212	144	$254.05	$106.14
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	92	92	$380.14	$159.51
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	70	24	$186.26	$72.15
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	65	60	$1704.89	$91.57
45384 Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery	56	56	$2206.41	$232.02
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	42	36	$352.50	$137.87
99213 Established patient office or other outpatient visit, typically 15 minutes	30	29	$161.33	$73.18
45378 Diagnostic exam of large bowel using a flexible endoscope	23	23	$1549.91	$189.81
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	14	14	$1546.00	$188.84
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	12	12	$1542.00	$189.17
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	12	12	$343.25	$142.82

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	276	181	$153.60	$71.51
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	97	84	$1579.69	$100.72
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	88	88	$242.64	$104.16
45378 Diagnostic exam of large bowel using a flexible endoscope	55	55	$1458.51	$188.51
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	45	42	$240.18	$103.40
45384 Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery	43	43	$2076.70	$191.64
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	33	33	$1967.97	$262.35
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	30	27	$342.13	$135.45
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	28	14	$180.50	$71.83
99202 New patient office or other outpatient visit, typically 20 minutes	21	21	$168.29	$73.59
45380 Biopsy of large bowel using an endoscope	21	21	$1848.95	$119.83
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	17	17	$1468.35	$189.62
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	13	13	$1474.00	$189.19

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	160	117	$148.66	$70.44
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	129	110	$94.07	$42.21
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	105	92	$1512.38	$104.18
99201 New patient office or other outpatient visit, typically 10 minutes	59	59	$95.88	$43.02
45384 Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery	36	36	$2007.78	$220.54
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	34	33	$329.94	$131.63
45378 Diagnostic exam of large bowel using a flexible endoscope	33	33	$1423.91	$188.30
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	32	32	$1417.97	$190.42
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	31	19	$174.16	$65.10
45380 Biopsy of large bowel using an endoscope	29	29	$1803.45	$181.09
47562 Removal of gallbladder using an endoscope	18	18	$3115.67	$674.85
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	15	15	$1911.40	$250.06
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	15	15	$1422.67	$189.78
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	14	14	$237.21	$104.29

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
97110 Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes	267	24	$84.44	$28.45
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	262	176	$92.83	$41.22
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	78	73	$1636.08	$98.28
99213 Established patient office or other outpatient visit, typically 15 minutes	64	53	$142.67	$69.27
97032 Application of electrical stimulation with therapist present, each 15 minutes	53	17	$42.87	$15.65
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	49	25	$168.51	$71.07
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	45	41	$322.42	$135.19
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	45	12	$160.36	$67.35
99202 New patient office or other outpatient visit, typically 20 minutes	43	43	$158.58	$71.97
45380 Biopsy of large bowel using an endoscope	34	34	$1943.24	$173.17
45384 Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery	30	30	$2132.10	$216.81
45378 Diagnostic exam of large bowel using a flexible endoscope	27	27	$1558.19	$185.92
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	26	26	$1588.38	$189.97
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	17	16	$2081.41	$251.10
99201 New patient office or other outpatient visit, typically 10 minutes	15	15	$94.00	$42.14
47562 Removal of gallbladder using an endoscope	12	12	$3030.17	$617.45

Medical Specialties & State Licenses

CMS Verified: 2022-12-07

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License IL 036091073

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Surgery

NUCC Taxonomy Code: 208600000X

State License MI 5101011210

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

036091073 (IL)

Commercial Insurance / Payer ID Fein Number

371342699 (IL)

Commercial Insurance / Payer ID Blue Cross/blue Shield

02706617 (IL)

Hospital & Practice Group Affiliations

Crittenden Community Hospital Llc

520 W Gum St, Marion, KY 420641516

Phone: 2709651042

Secondary Practice Locations

220 S Park Ave Fl 3

Herrin, IL 629483602

Phone: 6189422002

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners

Jonathan Edwards

Nurse Practitioner - Family

NPI 1164820312

Joy Preciado

Nurse Practitioner - Family

NPI 1306216098

Dr. Michael Vercimak , MD

Surgery

NPI 1366500852

Doctor of Medicine (M.D.)

Stacy Piller , APN

Nurse Practitioner - Primary Care

NPI 1508319914

Advanced Practice Nurse

Caitlin Engels-Arteaga

Physician Assistant - Medical

NPI 1790140580

Dr. Rebecca Salvani , MD

Obstetrics & Gynecology

NPI 1801982327

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active March 17, 2014

NPI status registered as active in NPPES database

📍

Updated Practice Location March 17, 2014

Registered at 1405 E 12TH ST, SUITE 500, MENDOTA, IL 613429010 (Tel: 8155391789)

📍

Updated Business Mailing Address March 17, 2014

Registered at 1401 E 12TH ST, MENDOTA, IL 613429216 (Tel: 8155391789)

👤

Provider Name / Credentials Updated March 17, 2014

Recorded as ERIC KIVISTO, DO

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 17, 2014

Surgery (License #036091073 in IL)

🟢

Initial NPI Registration & Enumeration July 06, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1447257316

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: July 06, 2005

Last Update: December 07, 2022

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1401 E 12th St

Mendota, IL 613429216

Phone: 8155391789

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.