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MIXAYPHONE BOUNVILAY RN
NPI 1053802074
Advanced Practice Midwife in Bellevue, WA

Active since May 24, 2018PECOS Enrolled
11511 NE 10TH ST, BELLEVUE, WA 98004(425) 502-3000 Get Directions Write a Review

NPPES record last updated: December 7, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 7, 2022, Apr 12, 2021, Dec 26, 2018 and 1 more (4 updates tracked since 2018).

About Mixayphone Bounvilay Rn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIXAYPHONE BOUNVILAY RN (NPI 1053802074) is an individual advanced practice midwife in Bellevue, Washington, licensed in Washington (AP60917564) and active in the NPI registry since May 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053802074
Entity TypeIndividualFemale
Primary Taxonomy367A00000X
Provider Legal NameMIXAYPHONE BOUNVILAYCredential: RN
Location Address11511 NE 10TH STBellevue, WA 98004-8578
Mailing Address11511 Ne 10th StBellevue, WA 98004-8578 · (425) 502-3000
Phone(425) 502-3000
Sole ProprietorNo
Enumeration DateMay 24, 2018
Last NPPES UpdateDecember 7, 20224 updates tracked since enumeration
NPPES CertifiedDecember 7, 2022
✔ NPI 1053802074 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAdvanced Practice MidwifePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367A00000X
License✔ Licensed in WA · AP60917564
Definition
Advanced practice midwifery encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproductive health; gynecologic health; and family planning services, including preconception care. Midwives also provide primary care for individuals from adolescence throughout the lifespan as well as care for the healthy newborn during the first 28 days of life. Midwives provide initial and ongoing comprehensive assessment, diagnosis, and treatment. Midwifery care includes health promotion, disease prevention, risk assessment and management, and individualized wellness education and counseling. Source: American College of Nurse-Midwives, www.midwife.org Additional Resources: See the American College of Nurse-Midwives, www.midwife.org, for more information on Certified Nurse-Midwives, Certified Midwives, the American Midwifery Certification Board (AMCB), and licensure.
11511 NE 10TH ST, Bellevue, WA 98004
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mixayphone Bounvilay Rn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Mixayphone Bounvilay reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc
655 mi
Internal Medicine
975 SERENO DRIVE
Vallejo, CA 94589
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1336222397 (707) 651-1000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98004 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$97.43 typical visit price
range $63.67 – $189.37
Typical copayment $24.35 (range $15.91 – $47.34)
Most-billed visit code 99203
Established Patient
$78.74 typical visit price
range $21.12 – $155.00
Typical copayment $19.68 (range $5.28 – $38.75)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PATSY C LAZAROUS MD
Internal Medicine
11511 NE 10TH ST
BELLEVUE, WA 98004
King County (425) 502-3000
SALMA F GHARIB M.D.
Emergency Medicine (Emergency Medical Services)
11511 NE 10TH ST
BELLEVUE, WA 98004
King County (425) 502-3000
PAULA J LINS P.A.-C
Physician Assistant
11511 NE 10TH ST
BELLEVUE, WA 98004
King County (425) 502-3000
SARAH PROCKO CNM
Advanced Practice Midwife
11511 NE 10TH ST
BELLEVUE, WA 98004
King County (425) 502-3000
BENNET M. WANG M.D.
Internal Medicine (Pulmonary Disease)
11511 NE 10TH ST
BELLEVUE, WA 98004
King County (425) 502-3000
CARA PRANGE PT
Physical Therapist
11511 NE 10TH ST
BELLEVUE, WA 98004
King County (800) 995-5658
DR. BRYN MCKINNON SMITH MD
Obstetrics & Gynecology
11511 NE 10TH ST
BELLEVUE, WA 98004
King County (425) 502-3000
MR. GARRETT MATTHEW KOSLAN CNM
Advanced Practice Midwife
11511 NE 10TH ST
BELLEVUE, WA 98004
King County (425) 502-3000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mixayphone Bounvilay's NPI number?

The NPI number for Mixayphone Bounvilay is 1053802074. It was assigned to this individual provider in the NPPES registry on May 24, 2018.

Where is Mixayphone Bounvilay located?

Mixayphone Bounvilay practices at 11511 NE 10th St, Bellevue, WA 98004. The listed phone number is (425) 502-3000.

What is Mixayphone Bounvilay's specialty?

The primary specialty registered for this NPI is Advanced Practice Midwife with taxonomy code 367A00000X.

Is Mixayphone Bounvilay enrolled in Medicare?

Yes. Mixayphone Bounvilay is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mixayphone Bounvilay's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mixayphone Bounvilay reassigns Medicare benefits to Permanente Medical Group Inc (Vallejo, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mixayphone Bounvilay's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mixayphone Bounvilay was last updated on December 7, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.