2026 NPPES data Orthopaedic Surgery of the Spine Physician NPI 1700853272 M.D.
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DON KOVALSKY, M.D.

Orthopaedic Surgery of the Spine Physician in MOUNT VERNON, Illinois. CMS National Plan and Provider Enumeration System profile including specialty classification, practice address, and Medicare prescribing data when reported.

Federal data — no proprietary rating. PlainDoctor publishes the actual CMS NPPES and Medicare records — NPI registration, specialty, practice location, and prescribing data — without a composite score or editorial opinion on top. Every field traces to a federal source.
Prescribing volume
3K
Medicare Part D claims · 397 beneficiaries · Orthopaedic Surgery of the Spine Physician avg: 362
Generic prescribing
100%
generic claims · 0% brand-name · higher generic rates reduce patient out-of-pocket costs
Industry payments
$37.78
2 payments · CMS Open Payments (Sunshine Act)
What the federal data reveals: DON KOVALSKY, M.D. is a Orthopaedic Surgery of the Spine Physician ([object Object]) practicing in MOUNT VERNON, Illinois with a Medicare Part D prescribing footprint of 3K claims across 397 beneficiaries — 0% brand-name prescribing . Industry payments of $37.78 across 2 transactions are disclosed under CMS Open Payments (Sunshine Act).

What stands out: DON KOVALSKY, M.D. filed 3,413 Medicare Part D claims in 2023 across MOUNT VERNON, Illinois. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.

Board-eligible specialty (heuristic — not verified)

DON KOVALSKY, M.D. practices in an ABMS-board-eligible specialty but we don't have enough CMS-participation signals to confirm active board-certified status. Consult CertificationMatters.org (the official ABMS public lookup).

DON KOVALSKY, M.D. at a glance

Quality data not reported

NPI registry status

Active

Issued 03/03/2006

NPI 1700853272

Primary specialty

Orthopaedic Surgery of the Spine Physician

Niche

1,773 US NPIs in this specialty

Medicare Part D claims

3,413 843% vs specialty avg

2023 prescription claims

Specialty avg: 362

Specialty distribution in Illinois

How Orthopaedic Surgery of the Spine Physician compares to other specialties among Illinois providers

Illinois providers

Orthopaedic Surgery of the Spine Physician share within Illinois

1. Orthopaedic Surgery of the Spine Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Orthopaedic Surgery of the Spine Physician share within Illinois

Specialty board-certification context

Estimated specialty board-certified rate — Orthopaedic Surgery of the Spine Physician (ABMS / AOA reference)

Quality data not reported
Est. board-certified rate
78%
Orthopaedic Surgery of the Spine Physician ABMS/AOA estimate

Est. board-certified rate (Orthopaedic Surgery of the Spine Physician) — ABMS / AOA estimate

0%100%78%
Est. board-certified rate (Orthopaedic Surgery of the Spine Physician) — ABMS / AOA estimate

The Merit-based Incentive Payment System (MIPS) scores providers 0–100 across four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities, weighted under 42 CFR §414.1380. Reporting is voluntary for many small practices, so absence of a MIPS score is not a quality signal.

Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus continuous Maintenance of Certification cycles. Verify any individual provider's status through certificationmatters.org (ABMS) or osteopathic.org (AOA).

DON KOVALSKY, M.D. is a Orthopaedic Surgery of the Spine Physician provider practicing in MOUNT VERNON, Illinois, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: M.D.. NPI: 1700853272. This profile includes practice location, specialty classification, and organizational affiliations from the CMS provider registry. Provider information is self-reported to CMS and updated monthly.

DON KOVALSKY, M.D. appears in the CMS NPPES registry as a Orthopaedic Surgery of the Spine Physician provider holding M.D. credentials at 4121 VETERANS MEMORIAL DR, MOUNT VERNON, IL, 62864, with a listed phone of (618) 242-3778. NPI 1700853272 was issued on 03/03/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what KOVALSKY most recently submitted to CMS rather than a vetted directory listing, which is why patients should always confirm the practice is still at this location before scheduling.

Medicare Part D records for calendar year 2023 show 3,413 prescription claims written by this provider, covering 397 Medicare beneficiaries and totaling roughly $103K in drug spend, split 0% brand-name and 100% generic by claim count, with an opioid prescribing rate of 55.3%. These figures capture only Medicare Part D — commercial insurance, Medicaid, and cash-pay prescriptions are not included, and any drug-beneficiary cell under 11 is suppressed by CMS for patient privacy.

Orthopaedic Surgery of the Spine Physician is a narrow specialty nationwide, with 1,773 enrolled providers across 51 states and an average of 362 Part D claims per prescriber, so the context for interpreting these metrics differs meaningfully from a primary-care baseline. Important: PlainDoctor is a directory of publicly available government data, not medical advice, a malpractice database, or a quality rating. Inclusion here does not imply a recommendation, and absence of complaints or sanctions on this page does not mean none exist — always verify credentials through the NPPES NPI Registry, your state medical board, and the ABMS or AOA before making healthcare decisions.

Practice Address

4121 VETERANS MEMORIAL DR
MOUNT VERNON, IL 62864

Provider Details

NPI 1700853272
Specialty Orthopaedic Surgery of the Spine Physician
Credentials M.D.
Gender Male
NPI Issued 03/03/2006

Industry payments received (2024) — CMS Open Payments transparency data

The federal Physician Payments Sunshine Act (part of the Affordable Care Act) requires drug and medical-device manufacturers + group purchasing organizations to publicly report payments and other transfers of value to physicians and teaching hospitals. The data below covers 2024 for DON KOVALSKY, M.D.. Source: openpaymentsdata.cms.gov.

Total received

$38

Largest payer

SI-BONE, INC.

Most common payment type

Food and Beverage

Industry payments are not necessarily indicators of bias — they include research funding, consulting fees for evidence-based work, royalties for inventions, food at conferences, and similar items. The disclosure exists for transparency. Read our methodology for how we interpret this data.

License & disciplinary context — Illinois IDFPR 2023 annual report

Aggregate state board data only — NOT a determination of any individual provider's status. The figures below describe statewide disciplinary activity across all ~42K Illinois medical licensees in 2023 — they are NOT specific to DON KOVALSKY, M.D.. To verify DON KOVALSKY, M.D.'s current license status, search the IDFPR public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

106
Total board actions, Illinois 2023
Across 103 cases
2.52
Actions per 1,000 licensees
Illinois statewide rate
probation
Most common action type
38 cases

IDFPR publishes annual disciplinary statistics as part of public-record reporting under each state's Administrative Procedure Act. See the full breakdown by action type and year on the Illinois disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Brand vs generic prescribing mix · Generic-heavy

DON KOVALSKY, M.D. — brand share 0.0%
Specialty average (est.)

0% brand-name claims vs 100% generic, on 3,413 2023 Medicare Part D claims.

The federal Medicare Part D Generic Dispensing Rate national benchmark sits near 90% generic / 10% brand for primary-care prescribers, per CMS Office of the Actuary 2024 estimates. Higher brand share is common in specialty prescribing where generic equivalents are not available.

Medicare Part D Prescribing Data

CMS Medicare Part D prescriber-level data for calendar year 2023.

3,413
Total Claims
$103K
Total Drug Cost
397
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
3,710
Total Day Supply
103,004
Brand vs Generic
0% brand / 100% generic
Brand Drug Cost
$6K
Generic Drug Cost
$97K
Opioid Claims
1,888 (55.3% rate)

Patient Demographics

Average Patient Age
70.7 years
Avg HCC Risk Score
1.52
Gender Split
62% female / 38% male
Age Distribution
<65: 88, 65-74: 166, 75-84: 111, 85+: 32

Top Prescribed Drugs (Medicare Part D)

Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.

Drug Claims
Tramadol Hcl
898
Hydrocodone-Acetaminophen
Hydrocodone/Acetaminophen
533
Gabapentin
450
Oxycodone-Acetaminophen
Oxycodone Hcl/Acetaminophen
370
Tizanidine Hcl
236
Cyclobenzaprine Hcl
143
Meloxicam
133
Pregabalin
113
Prednisone
95
Baclofen
57

* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.

Orthopaedic Surgery of the Spine Physician Overview

How DON KOVALSKY, M.D. fits within the Orthopaedic Surgery of the Spine Physician landscape nationally.

1,773
Orthopaedic Surgery of the Spine Physician Providers in US
51
States with Orthopaedic Surgery of the Spine Physician
362
Avg Claims per Provider

DON KOVALSKY, M.D.'s 3,413 claims are above the specialty average of 362.

Nearby Orthopaedic Surgery of the Spine Physician Providers in Illinois

Other clinicians with the same primary specialty enrolled in Illinois, drawn from the same CMS NPPES roster as KOVALSKY.

Compare Orthopaedic Surgery of the Spine Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is DON KOVALSKY, M.D.'s specialty?
DON KOVALSKY, M.D. specializes in Orthopaedic Surgery of the Spine Physician and practices in MOUNT VERNON, Illinois. Credentials: M.D..
How much does DON KOVALSKY, M.D. prescribe under Medicare Part D?
In 2023, DON KOVALSKY, M.D. wrote 3,413 Medicare Part D claims totaling $103K in drug costs for 397 beneficiaries.
Where is DON KOVALSKY, M.D. located?
DON KOVALSKY, M.D. is located at 4121 VETERANS MEMORIAL DR, MOUNT VERNON, IL, 62864. Phone: (618) 242-3778.
What is DON KOVALSKY, M.D.'s NPI number?
DON KOVALSKY, M.D.'s National Provider Identifier (NPI) is 1700853272, issued on 03/03/2006.
Does DON KOVALSKY, M.D. prescribe more brand-name or generic drugs?
DON KOVALSKY, M.D.'s prescribing is 0% brand-name and 100% generic drugs by claim count, with $6K in brand drug costs.
Does DON KOVALSKY, M.D. prescribe opioids?
Yes, DON KOVALSKY, M.D. had 1,888 opioid claims in 2023 with an opioid prescribing rate of 55.3%.
How many Orthopaedic Surgery of the Spine Physician providers are there in the US?
There are 1,773 Orthopaedic Surgery of the Spine Physician providers across 51 states in the US. The average Orthopaedic Surgery of the Spine Physician provider writes 362 Medicare Part D claims per year.
What drugs does DON KOVALSKY, M.D. prescribe most often?
Based on 2023 Medicare Part D data, DON KOVALSKY, M.D.'s most frequently prescribed drugs include Tramadol Hcl, Hydrocodone-Acetaminophen, Gabapentin. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does DON KOVALSKY, M.D. accept Medicare?
DON KOVALSKY, M.D. appears in CMS Medicare data with 3,413 Part D claims and 397 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify DON KOVALSKY, M.D.'s credentials?
DON KOVALSKY, M.D.'s NPI is 1700853272 with credentials M.D.. You can verify this through the NPPES NPI Registry, check state medical board records, and confirm board certification through the ABMS or AOA.

Data Sources

Provider Directory
CMS National Plan and Provider Enumeration System (NPPES), download.cms.gov/nppes, updated monthly. Contains NPI, specialty, credentials, and practice location.
Specialty Classification
NUCC Health Care Provider Taxonomy (nucc.org), the industry standard for classifying provider specialties in Medicare and Medicaid billing.
Prescribing Data
CMS Medicare Part D Prescriber Public Use File (2023). Includes claims, drug costs, beneficiaries, and opioid prescribing rates.
Limitations
Provider data is self-reported to CMS. Prescribing data reflects Medicare Part D only and does not include commercial insurance, Medicaid, or cash prescriptions. Claims below 11 beneficiaries are suppressed by CMS for privacy.

See our complete data methodology for details on how we collect and process government data.

Data as of April 2026 (NPPES) / 2023 (Medicare Part D). Source: Centers for Medicare & Medicaid Services (CMS).

Disclaimer: Data from CMS NPPES and Medicare Part D. PlainDoctor does not rate or rank providers. Provider information is self-reported and may not be current. Always verify information directly with the provider. About · Methodology