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

Ilya A Khotimsky, MD

Individual provider Anesthesiology Physician · NPI 1245563329

Ilya A Khotimsky, MD is an Anesthesiology in Fond Du Lac, Wisconsin. Qualified in 1999, 27 years ago. Practices with Vituity-Wisconsin Anesthesia SC, a 144-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
27
Licensed in
WI
In the registry since
2009
Specialties on file
3
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

430 E Division St
Fond Du Lac, WI 54935-4560
Phone: (920) 929-2300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence 56854 (WI)
Anesthesiology Physician Taxonomy 207L00000X · Licence 56854-20 (WI)
Critical Care Medicine (Anesthesiology) Physician Taxonomy 207LC0200X · Licence 56854-20 (WI)

Record details

NPI number1245563329
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedSeptember 8, 2009
Last updated in NPPESDecember 30, 2021
Certification dateDecember 30, 2021

Medicare enrollment

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

Medicare specialtyANESTHESIOLOGY
Medical schoolOTHER
Graduated 1999 (27 years in practice)
Group practice Vituity-Wisconsin Anesthesia Sc — 144 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations8 on file with Medicare

Other providers in Fond Du Lac