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DR. JERRY NELSON MIXON MD
NPI 1366799090
Family Medicine - Adult Medicine in Kirkland, WA

Active since August 13, 2012Opted out of Medicare · through Aug 14, 2027
9757 NE JUANITA DR, 202, KIRKLAND, WA 98034(425) 605-8715(425) 654-0211 Get Directions Write a Review

NPPES record last updated: August 13, 2012. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Dr. Jerry Nelson Mixon Md NPPES

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

DR. JERRY NELSON MIXON MD (NPI 1366799090) is an individual adult medicine provider in Kirkland, Washington, licensed in Washington (MD00023643) and active in the NPI registry since August 2012. He has opted out of Medicare through August 14, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1366799090
Entity TypeIndividualMale
Primary Taxonomy207QA0505X
Provider Legal NameDR. JERRY NELSON MIXONCredential: MD
Location Address9757 NE JUANITA DR, 202Kirkland, WA 98034-4299
Mailing Address9757 Ne Juanita Dr, 202Kirkland, WA 98034-4299 · (425) 605-8715 · Fax (425) 654-0211
Phone(425) 605-8715
Fax(425) 654-0211
Sole ProprietorYes
Enumeration DateAugust 13, 2012
✔ NPI 1366799090 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Adult MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0505X
License✔ Licensed in WA · MD00023643
Definition
The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.
9757 NE JUANITA DR, Kirkland, WA 98034
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Jerry Nelson Mixon Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from August 14, 2015 through August 14, 2027.

Opt-Out Effective DateAugust 14, 2015
Opt-Out In Effect ThroughAugust 14, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98034 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
$111.00 typical visit price
range $21.12 – $155.00
Typical copayment $27.75 (range $5.28 – $38.75)
Most-billed visit code 99214
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 9

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

LONGEVITY MEDICAL CLINIC
Specialist
9757 NE JUANITA DR, SUITE 200
KIRKLAND, WA 98034
King County (425) 576-9272
MRS. JANET ROSE CANNIFF LMHC
Counselor (Mental Health)
9757 NE JUANITA DR, SUITE 102
KIRKLAND, WA 98034
King County (800) 433-8373
MS. DEBORAH D GRAY MSW, MPA
Social Worker (Clinical)
9757 NE JUANITA DR, SUITE 129
KIRKLAND, WA 98034
King County (206) 819-2017
ANGELA FARRAR SMALL
Social Worker (Clinical)
9757 NE JUANITA DR, STE 214
KIRKLAND, WA 98034
King County (425) 286-8727
DR. PADMINI BHASKAR M.D.
Specialist
9757 NE JUANITA DR, SUITE 200
KIRKLAND, WA 98034
King County (425) 576-9272
MEAGAN MCKEE
Counselor (Mental Health)
9757 NE JUANITA DR
KIRKLAND, WA 98034
King County (206) 669-2310
LONGEVITY LABORATORY, LLC
Clinical Medical Laboratory
9757 NE JUANITA DR, 202
KIRKLAND, WA 98034
King County (425) 605-8715
JESSICA PSENSKI LMHCA
Counselor (Mental Health)
9757 NE JUANITA DR
KIRKLAND, WA 98034
King County (425) 638-2127

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 Jerry Mixon's NPI number?

The NPI number for Jerry Mixon is 1366799090. It was assigned to this individual provider in the NPPES registry on August 13, 2012.

Where is Jerry Mixon located?

Jerry Mixon practices at 9757 NE Juanita Dr 202, Kirkland, WA 98034. The listed phone number is (425) 605-8715.

What is Jerry Mixon's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.

Is Jerry Mixon enrolled in Medicare?

No. Jerry Mixon has opted out of Medicare through August 14, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Jerry Mixon was last updated on August 13, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.