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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: October 25, 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, billing reassignment, and ordering and referring status from CMS.

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 IDI20250905001545

Medicare Billing Reassignments

8

Medicare enrollment records show Owen Adolphsen reassigns Medicare billing to 8 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Northern Anesthesia Providers PC
0.2 mi
Anesthesiology
602 JACKSON ST
Petoskey, MI 49770
  • Reassigned Medicare billing, Michigan enrollment
  • 39 clinicians in this Medicare group
NPI 1396834628 (231) 348-2795
Munson Medical Group
4.1 mi
Family Medicine
8881 M 119
Harbor Springs, MI 49740
  • Reassigned Medicare billing, Michigan enrollment
  • 191 clinicians in this Medicare group
NPI 1629740972 (231) 347-5400
Munson Healthcare Charlevoix Hospital
11 mi
Rural Health
223 N PARK ST
Boyne City, MI 49712
  • Reassigned Medicare billing, Michigan enrollment
  • 96 clinicians in this Medicare group
NPI 1255779484 (231) 582-5314
Munson Healthcare Otsego Memorial Hospital
28 mi
Nurse Anesthetist, Certified Registered
825 N CENTER AVE
Gaylord, MI 49735
  • Reassigned Medicare billing, Michigan enrollment
  • 63 clinicians in this Medicare group
NPI 1376568865 (989) 731-2100
Munson Medical Center
54 mi
Anesthesiology
1105 SIXTH ST
Traverse City, MI 49684
  • Reassigned Medicare billing, Michigan enrollment
  • 74 clinicians in this Medicare group
NPI 1710735287 (231) 935-5710
Munson Healthcare Cadillac
81 mi
Anesthesiology
400 HOBART ST
Cadillac, MI 49601
  • Reassigned Medicare billing, Michigan enrollment
  • 62 clinicians in this Medicare group
NPI 1871991596 (231) 935-6080
Anesthesia Patient Services Of Pennsylvania LLC
664 mi
Anesthesiology
1305 WALT WHITMAN RD STE 300
Melville, NY 11747
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 45 clinicians in this Medicare group
NPI 1659752921 (516) 945-3000
North American Partners In Anesthesia, Pennsylvania , LLC
664 mi
Anesthesiology
1305 WALT WHITMAN RD STE 300
Melville, NY 11747
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 928 clinicians in this Medicare group
NPI 1639137854 (516) 946-3000

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

Hospital Affiliations CMS Care Compare 2

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

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.

Which organizations bill Medicare for Owen Adolphsen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Owen Adolphsen reassigns Medicare benefits to 8 organizations: Northern Anesthesia Providers PC (Petoskey, MI), Munson Medical Group (Harbor Springs, MI), Munson Healthcare Charlevoix Hospital (Boyne City, MI), Munson Healthcare Otsego Memorial Hospital (Gaylord, MI), Munson Medical Center (Traverse City, MI) and 3 more organizations, listed in the Medicare section above. 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 Owen Adolphsen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Owen Adolphsen affiliated with any hospitals?

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

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 4 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.