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OWEN ADOLPHSEN
NPI 1063241230
Nurse Anesthetist, Certified Registered in Petoskey, MI

Active since July 29, 2024Accepts Medicare Assignment
416 CONNABLE AVE, PETOSKEY, MI 49770(231) 348-2795(231) 348-2031 Get Directions Write a Review

NPPES record last updated: June 1, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 1, 2026, May 6, 2026, Jun 6, 2025 and 1 more (4 updates tracked since 2024).

About Owen Adolphsen NPPES

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

OWEN ADOLPHSEN (NPI 1063241230) is an individual nurse anesthetist, certified registered in Petoskey, Michigan, licensed in Michigan (4704351318) and active in the NPI registry since July 2024. He is affiliated with Munson Medical Center and is a graduate of Other (2025).

NPPES Registry Identity

NPI1063241230
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameOWEN ADOLPHSEN
Location Address416 CONNABLE AVEPetoskey, MI 49770-2212
Mailing Address602 Jackson StPetoskey, MI 49770-2220 · (231) 348-2795 · Fax (231) 348-2031
Phone(231) 348-2795
Fax(231) 348-2031
Sole ProprietorYes
Medical School CMSOtherGraduated 2025
Enumeration DateJuly 29, 2024
Last NPPES UpdateJune 1, 20264 updates tracked since enumeration
NPPES CertifiedJune 1, 2026
✔ NPI 1063241230 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in MI · 4704351318
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.
Also ListedRegistered NurseTaxonomy 163W00000X · License RN757422 (PA)
416 CONNABLE AVE, Petoskey, MI 49770
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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

Owen Adolphsen 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 ID446779185
PECOS Enrollment IDI20250527000288, I20250905001545

Hospital Affiliations CMS Care Compare 3

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

Munson Medical Center

Acute Care Hospitals · Traverse City, MI
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number230097
Location1105 Sixth StreetTraverse City, MI 49684 · Grand Traverse County
Emergency services Birthing friendly

Mclaren Northern Michigan

Acute Care Hospitals · Petoskey, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number230105
Location416 Connable AvePetoskey, MI 49770 · Emmet County
Emergency services Birthing friendly

Upmc Hamot

Acute Care Hospitals · Erie, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390063
Location201 State StreetErie, PA 16550 · Erie County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49770 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
$126.15 typical visit price
range $54.34 – $166.68
Typical copayment $31.53 (range $13.58 – $41.67)
Most-billed visit code 99204
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
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.

KEELY MARIE BLOSH NP
Nurse Practitioner
416 CONNABLE AVE
PETOSKEY, MI 49770
Emmet County (231) 487-4000
GARY H SHAW M.D.
Internal Medicine (Nephrology)
416 CONNABLE AVE
PETOSKEY, MI 49770
Emmet County (231) 487-7303
BAY RADIATION ONCOLOGY, PLLC
Radiology (Radiation Oncology)
416 CONNABLE AVE
PETOSKEY, MI 49770
Emmet County (231) 487-4209
DR. JANEAN HAGGINS-DABNEY M.D.
Internal Medicine
416 CONNABLE AVE
PETOSKEY, MI 49770
Emmet County (231) 922-9270
MCLAREN NORTHERN MICHIGAN
Psychiatric Unit
416 CONNABLE AVE
PETOSKEY, MI 49770
Emmet County (231) 487-4000
LYNDA BARTOSH RTRM, RPA
Radiology Practitioner Assistant
416 CONNABLE AVE
PETOSKEY, MI 49770
Emmet County (231) 487-4000
NATALIA I RUSH MD PC
Pathology (Anatomic Pathology & Clinical Pathology)
416 CONNABLE AVE
PETOSKEY, MI 49770
Emmet County (231) 487-4000
DR. MARK JAMES BIELACZYC M.D.
Anesthesiology
416 CONNABLE AVE
PETOSKEY, MI 49770
Emmet County (231) 348-2795

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 Owen Adolphsen's NPI number?

The NPI number for Owen Adolphsen is 1063241230. It was assigned to this individual provider in the NPPES registry on July 29, 2024.

Where is Owen Adolphsen located?

Owen Adolphsen practices at 416 Connable Ave, Petoskey, MI 49770. The listed phone number is (231) 348-2795.

What is Owen Adolphsen's specialty?

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

Is Owen Adolphsen enrolled in Medicare?

Yes. Owen Adolphsen 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.

Is Owen Adolphsen affiliated with any hospitals?

According to CMS data, Owen Adolphsen is affiliated with Munson Medical Center, Mclaren Northern Michigan and Upmc Hamot.

When was this NPI record last updated?

The NPPES record for Owen Adolphsen was last updated on June 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.