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MIKELLE JENEE ADAMCZYK CRNA
NPI 1053580936
Nurse Anesthetist, Certified Registered in Portland, OR

Active since February 26, 2008PECOS EnrolledAccepts Medicare Assignment
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239(503) 494-7641(503) 494-4661 Get Directions Write a Review

NPPES record last updated: June 18, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mikelle Jenee Adamczyk Crna NPPES

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

MIKELLE JENEE ADAMCZYK CRNA (NPI 1053580936) is an individual nurse anesthetist, certified registered in Portland, Oregon, licensed in Oregon (201900978CRNA) and active in the NPI registry since February 2008. She is enrolled in Medicare PECOS, is affiliated with Saint Alphonsus Regional Medical Center, and maintains a secondary practice location in Southfield.

NPPES Registry Identity

NPI1053580936
Entity TypeIndividualFemale
Primary Taxonomy367500000X
Provider Legal NameMIKELLE JENEE ADAMCZYKCredential: CRNA
Location Address3181 SW SAM JACKSON PARK RDPortland, OR 97239-3011
Mailing Address3181 Sw Sam Jackson Park Rd, Mail Code Sjh-2Portland, OR 97239 · (503) 494-7246 · Fax (503) 494-8368
Phone(503) 494-7641
Fax(503) 494-4661
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateFebruary 26, 2008
Last NPPES UpdateJune 18, 2025
NPPES CertifiedJune 18, 2025
✔ NPI 1053580936 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
Licenses✔ Licensed in OR · 201900978CRNA✔ Licensed in MI · 4704217848
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
3181 SW SAM JACKSON PARK RD, Portland, OR 97239
Open in Google Maps ↗

Secondary Practice Location 1

Location 116001 W 9 Mile RdSouthfield, MI 48075-4818 · Phone (248) 849-5806 · Fax (248) 849-5489

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mikelle Jenee Adamczyk Crna 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 ID3375622939
PECOS Enrollment IDI20191021003217, I20250716002585, I20251223000999
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.

Medicare Billing Reassignments

5

Medicare enrollment records show Mikelle Adamczyk reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Hospitalist Medicine Physicians Of Washington - Tcs
4.1 mi
Anesthesiology
4805 NE GLISAN ST
Portland, OR 97213
  • Reassigned Medicare billing, Oregon enrollment
  • 419 clinicians in this Medicare group
NPI 1649816380 (503) 215-1111
St Alphonsus Professional Medical Services LLC
343 mi
Anesthesiology
1055 N CURTIS RD
Boise, ID 83706
  • Reassigned Medicare billing, Idaho enrollment
  • 188 clinicians in this Medicare group
NPI 1386677524 (208) 367-6416
Allina Health System
1,343 mi
Family Medicine
310 S MAIN ST
Lamberton, MN 56152
  • Reassigned Medicare billing, Minnesota enrollment
  • 3,733 clinicians in this Medicare group
NPI 1467090159 (507) 752-7375
Northstar Anesthesia Of Michigan II PC
1,620 mi
Anesthesiology
6225 N STATE HIGHWAY 161 STE 200
Irving, TX 75038
  • Reassigned Medicare billing, Michigan enrollment
  • 283 clinicians in this Medicare group
NPI 1437268026 (214) 687-0001
University Anesthesiology Associates, LLC
Anesthesiology
3181 SW SAM JACKSON PARK RD, MAILCODE: SJH-2
Portland, OR 97239
  • Reassigned Medicare billing, Oregon enrollment
  • 279 clinicians in this Medicare group
NPI 1841217817 (503) 494-4910

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims

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.

Anesthesia for other procedure on large bowel using an endoscope 00811
Anesthesia for an endoscopic procedure on the large bowel ensures comfort and relaxation during the procedure. You'll be given medication to make you drowsy or asleep, eliminating any discomfort. The medication can be administered through a vein or inhaled.
12 services12 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Saint Alphonsus Regional Medical Center

Acute Care Hospitals · Boise, ID
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number130007
Location1055 North Curtis RoadBoise, ID 83706 · Ada County
Emergency services Birthing friendly

Abbott Northwestern Hospital

Acute Care Hospitals · Minneapolis, MN
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number240057
Location800 East 28th StreetMinneapolis, MN 55407 · Hennepin County
Emergency services Birthing friendly

Ohsu Hospital And Clinics

Acute Care Hospitals · Portland, OR
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number380009
Location3181 SW Sam Jackson Park RoadPortland, OR 97239 · Multnomah County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97239 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
$134.16 typical visit price
range $58.99 – $176.88
Typical copayment $33.54 (range $14.74 – $44.22)
Most-billed visit code 99204
Established Patient
$73.28 typical visit price
range $19.32 – $144.79
Typical copayment $18.32 (range $4.83 – $36.19)
Most-billed visit code 99213
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.

DONALD RICHARD SULLIVAN MD
Internal Medicine (Pulmonary Disease)
3181 SW SAM JACKSON PARK RD, UHN67
PORTLAND, OR 97239
Multnomah County (503) 494-6949
MRS. ANJALEE NIX ROWE NP
Nurse Practitioner (Acute Care)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-3988
REEM HASAN MD
Internal Medicine
3181 SW SAM JACKSON PARK RD, PPV 350
PORTLAND, OR 97239
Multnomah County (503) 494-8562
DR. AMANDA D BALL PSY.D
Psychologist (Clinical)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-6176
SUNSHINE WELSCH LMT
Massage Therapist
3181 SW SAM JACKSON PARK RD, 7D19
PORTLAND, OR 97239
Multnomah County (503) 494-8349
DR. ROBERT GENE MEALER M.D., PH.D.
Psychiatry & Neurology (Psychiatry)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-6176
GREGORY HALL MD
Radiology (Diagnostic Radiology)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 418-0990
DR. BURHAN AHMED MIAN MD
Student in an Organized Health Care Education/Training Program
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-8311

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 Mikelle Adamczyk's NPI number?

The NPI number for Mikelle Adamczyk is 1053580936. It was assigned to this individual provider in the NPPES registry on February 26, 2008.

Where is Mikelle Adamczyk located?

Mikelle Adamczyk practices at 3181 SW Sam Jackson Park Rd, Portland, OR 97239. The listed phone number is (503) 494-7641.

What is Mikelle Adamczyk's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Mikelle Adamczyk enrolled in Medicare?

Yes. Mikelle Adamczyk 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.

Which organizations bill Medicare for Mikelle Adamczyk's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mikelle Adamczyk reassigns Medicare benefits to 5 organizations: Hospitalist Medicine Physicians Of Washington - Tcs (Portland, OR), St Alphonsus Professional Medical Services LLC (Boise, ID), Allina Health System (Lamberton, MN), Northstar Anesthesia Of Michigan II PC (Irving, TX) and University Anesthesiology Associates, LLC (Portland, OR). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mikelle Adamczyk's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mikelle Adamczyk accept?

Health plans from Moda Health Plan, Inc. list Mikelle Adamczyk as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Mikelle Adamczyk affiliated with any hospitals?

According to CMS data, Mikelle Adamczyk is affiliated with Saint Alphonsus Regional Medical Center, Abbott Northwestern Hospital and Ohsu Hospital And Clinics.

When was this NPI record last updated?

The NPPES record for Mikelle Adamczyk was last updated on June 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.