JUAN GUSTAVO NIX (M.D.) – Emergency Medicine Physician, NPI 1508939661

JUAN GUSTAVO NIX (M.D.) is a healthcare provider. based in Bolivar, Missouri. specializing in EMERGENCY MEDICINE. They hold the professional credentials M.D.. They hold a License No. MOR1G61 (MO). The NPI Number for JUAN GUSTAVO NIX (M.D.) is 1508939661

Main info

Male
43 Years Of Experience
Accepts Medicare Assignment
Name
JUAN GUSTAVO NIX (M.D.)
NPI
1508939661
Phone
(417) 326-6000
Address
1500 N OAKLAND AVE
Enumeration Date
16 November 2006
Last Update Date
2 December 2009

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4173286040
Graduation Year
1983 (43 years ago)
PAC ID
6608918230
Group Practice PAC ID
4183528169
Professional Enrollment ID
I20100120000799
Address ID
MO656133099BO1500XAVEX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,354 EMERGENCY MEDICINE in MO

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Provider Addresses for JUAN GUSTAVO NIX (M.D.)

  • Citizens Memorial Hospital, 1500, North Oakland Avenue, Bolivar, Polk County, Missouri, 65613, United States

    BOLIVAR, MO 656133011

    Phone: (417) 326-6000

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-01-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100120000799IEmergency MedicineMOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 65613)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4183528169View full group profile
NameSpecialtyState
Family PracticeMO
-MO
-MO
Urology, Internal MedicineMO
-MO
Dermatology, Micrographic Dermatologic Surgery (Mds), DermatologyMO
Hospitalist, Internal MedicineKS
Cardiovascular Disease (Cardiology)MO
Nurse PractitionerMO
Diagnostic RadiologyMO

Reviews

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Frequently asked questions

What NPI should I save for JUAN GUSTAVO NIX (M.D.)?
Save NPI 1508939661 if you need a stable reference for JUAN GUSTAVO NIX (M.D.).
Is JUAN GUSTAVO NIX (M.D.) currently active in the NPI registry?
CMS-published data lists JUAN GUSTAVO NIX (M.D.) as an active registrant.
Can you summarize JUAN GUSTAVO NIX (M.D.)'s specialty in plain language?
Clinically, the directory lists JUAN GUSTAVO NIX (M.D.) with Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
Where does public data place JUAN GUSTAVO NIX (M.D.)?
The snapshot lists Bolivar, Missouri for JUAN GUSTAVO NIX (M.D.); download NPPES for the complete set.
What if Bolivar, Missouri seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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