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

Dr. Michael Mstislavovich Ivanitsky, MD

Individual provider Orthopaedic Surgery Physician · NPI 1003837410

Dr. Michael Mstislavovich Ivanitsky, MD is an Orthopedic Surgery in Coquille, Oregon. Graduated from Mayo Medical School in 1993, 33 years ago. Practices with Lower Umpqua Hospital District, a 44-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
33
Trained at
Mayo Medical School
Licensed in
OR
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

940 E 5th St
Coquille, OR 97423-1699
Phone: (541) 396-3111
Fax: (541) 396-8135
Show map & directions

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

Specialties & licences

Orthopaedic Surgery Physician (primary) Taxonomy 207X00000X · Licence MD22589 (OR)

Record details

NPI number1003837410
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 21, 2006
Last updated in NPPESSeptember 4, 2020
Certification dateSeptember 4, 2020

Medicare enrollment

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

Medicare specialtyORTHOPEDIC SURGERY
Medical schoolMAYO MEDICAL SCHOOL
Graduated 1993 (33 years in practice)
Group practice Lower Umpqua Hospital District — 44 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount