Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Dmitriy Stalivonenko, MD

Individual provider Anesthesiology Physician · NPI 1710966395

Dr. Dmitriy Stalivonenko, MD is an Anesthesiology in Kenosha, Wisconsin. Qualified in 1988, 38 years ago. Practices with Aurora Medical Group, Inc, a 3,741-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
38
Licensed in
WI
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

10400 75th St
Kenosha, WI 53142-7884
Phone: (414) 358-5443
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3801 Spring St, Racine, WI 53405-1667 — (262) 687-4011

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence 40879-020 (WI)

Record details

NPI number1710966395
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJanuary 12, 2006
Last updated in NPPESNovember 6, 2023
Certification dateNovember 6, 2023
Mailing addressPo Box 735044, Chicago, IL 60673-5044

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyANESTHESIOLOGY
Medical schoolOTHER
Graduated 1988 (38 years in practice)
Group practice Aurora Medical Group, Inc. — 3741 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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