DR. JESSE WILLIAM MIX DO
NPI 1538415351
Family Medicine in Boise, ID

Q: What is Jesse Mix's NPI number?

The NPI number for Jesse Mix is 1538415351. It was assigned to this individual provider in the NPPES registry on July 30, 2012.

Q: What is Jesse Mix's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Jesse Mix was last updated on February 25, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since July 30, 2012PECOS Enrolled

500 W FORT ST, # 111, BOISE, ID 83702(208) 422-1000(208) 422-1319 Get Directions Write a Review

NPPES record last updated: February 25, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 25, 2022, Jul 8, 2020, Aug 6, 2019 (3 updates tracked since 2019).

On this page

About Dr. Jesse William Mix Do NPPES

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

DR. JESSE WILLIAM MIX DO (NPI 1538415351) is an individual family medicine provider in Boise, Idaho, licensed in Idaho (O-1380) and active in the NPI registry since July 2012. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1538415351

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. JESSE WILLIAM MIXCredential: DO

Location Address500 W FORT ST, # 111Boise, ID 83702

Mailing Address500 W. Fort St., # 111Boise, ID 83702 · (208) 422-1000 · Fax (208) 422-1319

Phone(208) 422-1000

Fax(208) 422-1319

Sole ProprietorNo

Enumeration DateJuly 30, 2012

Last NPPES UpdateFebruary 25, 20223 updates tracked since enumeration

NPPES CertifiedFebruary 25, 2022

✔ NPI 1538415351 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in ID · O-1380✔ Licensed in AZ · 6880

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

500 W FORT ST, Boise, ID 83702

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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 (PECOS)

Dr. Jesse William Mix Do 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83702 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

$81.13 typical visit price

range $52.44 – $160.17

Typical copayment $20.28 (range $13.11 – $40.04)

Most-billed visit code 99203

Established Patient

$93.26 typical visit price

range $16.68 – $130.93

Typical copayment $23.31 (range $4.17 – $32.73)

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 20

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

JESSICA ANN BERNOTSKI RDH

Dental Hygienist

500 W FORT ST
BOISE, ID 83702

Ada County (208) 422-1000

ROBERT FISHER

Registered Nurse (Gastroenterology)

500 W FORT ST
BOISE, ID 83702

Ada County (208) 422-1092

LUKE DANIEL HANSEN MD

Psychiatry & Neurology (Psychiatry)

500 W FORT ST
BOISE, ID 83702

Ada County (208) 422-1000

CHRISTOPHER M GUTIERREZ

Registered Nurse (Gastroenterology)

500 W FORT ST
BOISE, ID 83702

Ada County (208) 422-1000

DR. MICHAEL GLOVER M.D.

Orthopaedic Surgery (Orthopaedic Surgery of the Spine)

500 W FORT ST, MAIL CODE #112
BOISE, ID 83702

Ada County (208) 422-1000

DR. ANN DECKER TROTTER PHD

Psychologist (Clinical)

500 W FORT ST
BOISE, ID 83702

Ada County (208) 422-1000

REBECCA COTTERELL RN-BC, BSN

Registered Nurse

500 W FORT ST
BOISE, ID 83702

Ada County (208) 422-1000

PHILIP RESIN ELACKATT RN

Registered Nurse (Pain Management)

500 W FORT ST
BOISE, ID 83702

Ada County (986) 256-1766

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 Jesse Mix's NPI number?

The NPI number for Jesse Mix is 1538415351. It was assigned to this individual provider in the NPPES registry on July 30, 2012.

Where is Jesse Mix located?

Jesse Mix practices at 500 W Fort St # 111, Boise, ID 83702. The listed phone number is (208) 422-1000.

What is Jesse Mix's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Jesse Mix enrolled in Medicare?

Yes. Jesse Mix is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jesse Mix was last updated on February 25, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.