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GEORGE JORY WIXSOM MD
NPI 1114094612
Psychiatry & Neurology - Child & Adolescent Psychiatry in Long Beach, NY

Active since November 29, 2006PECOS Enrolled
20 W PARK AVE, SUITE 310B, LONG BEACH, NY 11561(516) 978-1612(516) 374-2261 Get Directions Write a Review

NPPES record last updated: June 28, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About George Jory Wixsom Md NPPES

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

GEORGE JORY WIXSOM MD (NPI 1114094612) is an individual child & adolescent psychiatry provider in Long Beach, New York, licensed in New York (224685-1) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114094612
Entity TypeIndividualMale
Primary Taxonomy2084P0804X
Provider Legal NameGEORGE JORY WIXSOMCredential: MD
Location Address20 W PARK AVE, SUITE 310BLong Beach, NY 11561-2033
Mailing Address50 W. Hawthorne Ave.Woodmere, NY 11598 · (516) 569-6600 · Fax (516) 374-2261
Phone(516) 978-1612
Fax(516) 374-2261
Sole ProprietorNo
Enumeration DateNovember 29, 2006
Last NPPES UpdateJune 28, 2013
✔ NPI 1114094612 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
License✔ Licensed in NY · 224685-1
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
20 W PARK AVE, Long Beach, NY 11561
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Other Identifiers 2

Medicare ID-Type Unspecified157BN1NY
Medicaid02406628NY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

George Jory Wixsom Md 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.

Other Providers at the Same Location NPPES 2

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

MEAGHAN ALEXA GRABOWSKI LMHC
Counselor (Mental Health)
20 W PARK AVE
LONG BEACH, NY 11561
Nassau County (516) 792-5850
NICOLETTE ROSE ILLIANO
Counselor (Mental Health)
20 W PARK AVE
LONG BEACH, NY 11561
Nassau County (646) 280-9244

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 George Wixsom's NPI number?

The NPI number for George Wixsom is 1114094612. It was assigned to this individual provider in the NPPES registry on November 29, 2006.

Where is George Wixsom located?

George Wixsom practices at 20 W Park Ave Suite 310B, Long Beach, NY 11561. The listed phone number is (516) 978-1612.

What is George Wixsom's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is George Wixsom enrolled in Medicare?

Yes. George Wixsom is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for George Wixsom was last updated on June 28, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.