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DR. JACK LEON-MAX MUTNICK M.D.
NPI 1487601316
Internal Medicine in Edina, MN

Active since May 27, 2006PECOS EnrolledAccepts Medicare Assignment
3939 W 69TH ST STE A, EDINA, MN 55435(612) 930-8462(800) 785-5608 Get Directions Write a Review

NPPES record last updated: December 11, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 11, 2024, Oct 12, 2024, Feb 20, 2023 and 3 more (6 updates tracked since 2016).

About Dr. Jack Leon-max Mutnick M.d. NPPES

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

DR. JACK LEON-MAX MUTNICK M.D. (NPI 1487601316) is an individual internal medicine provider in Edina, Minnesota, licensed in Minnesota (48180) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS and is a graduate of University Of Nevada School Of Medicine (2004).

NPPES Registry Identity

NPI1487601316
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. JACK LEON-MAX MUTNICKCredential: M.D.
Location Address3939 W 69TH ST STE AEdina, MN 55435-2001
Mailing Address3440 Molina StShakopee, MN 55379-5444 · (714) 296-6777 · Fax (800) 785-5608
Phone(612) 930-8462
Fax(800) 785-5608
Sole ProprietorNo
Medical School CMSUniversity Of Nevada School Of MedicineGraduated 2004
Enumeration DateMay 27, 2006
Last NPPES UpdateDecember 11, 20246 updates tracked since enumeration
NPPES CertifiedDecember 11, 2024
✔ NPI 1487601316 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MN · 48180
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedAllergy & ImmunologyTaxonomy 207K00000X · License 48180 (MN)
3939 W 69TH ST STE A, Edina, MN 55435
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Jack Leon-max Mutnick M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1658400866
PECOS Enrollment IDI20100526001002
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.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
199 services69 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
59 services38 patients
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490
Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
52 services23 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
18 services18 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55435 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
$127.61 typical visit price
range $56.00 – $168.28
Typical copayment $31.90 (range $14.00 – $42.07)
Most-billed visit code 99204
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
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.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
1 supplier12 claims12 services$177.79 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Jack Mutnick's NPI number?

The NPI number for Jack Mutnick is 1487601316. It was assigned to this individual provider in the NPPES registry on May 27, 2006.

Where is Jack Mutnick located?

Jack Mutnick practices at 3939 W 69th St Ste A, Edina, MN 55435. The listed phone number is (612) 930-8462.

What is Jack Mutnick's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Jack Mutnick enrolled in Medicare?

Yes. Jack Mutnick is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Jack Mutnick was last updated on December 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months 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.