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

Dr. Myriam Jacynthe Donovitch, MD

Individual provider Sports Medicine (Family Medicine) Physician · NPI 1093332389

Dr. Myriam Jacynthe Donovitch, MD is a Sports Medicine in Kenosha, Wisconsin. Qualified in 2019, 7 years ago. Practices with Advantage Physical Therapy and Sports Rehab, LLC, a 286-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
7
Licensed in
WI
In the registry since
2020
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

7401 104th Ave Ste 110
Kenosha, WI 53142-7845
Phone: (262) 764-5595
Show map & directions

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

Additional practice locations (1)

  • 420 Delaware St Se, Minneapolis, MN 55455-0341 — (612) 626-2338

Specialties & licences

Sports Medicine (Family Medicine) Physician (primary) Taxonomy 207QS0010X · Licence 83968-20 (WI)

Record details

NPI number1093332389
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 2, 2020
Last updated in NPPESNovember 11, 2024
Certification dateNovember 11, 2024

Medicare enrollment

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

Medicare specialtySPORTS MEDICINE
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Advantage Physical Therapy And Sports Rehab, Llc — 286 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations9 on file with Medicare

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