CHRISTOPHER BLAINE MIKULIC PSYD
NPI 1548759418
Psychologist - Clinical in Lake Oswego, OR

Active since May 07, 2018PECOS EnrolledAccepts Medicare Assignment
4004 KRUSE WAY PL STE 300, LAKE OSWEGO, OR 97035(503) 216-1500 Get Directions Write a Review

NPPES record last updated: February 2, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Christopher Blaine Mikulic Psyd NPPES

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

CHRISTOPHER BLAINE MIKULIC PSYD (NPI 1548759418) is an individual clinical provider in Lake Oswego, Oregon, licensed in Oregon (3693) and active in the NPI registry since May 2018. He is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1548759418
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameCHRISTOPHER BLAINE MIKULICCredential: PSYD
Location Address4004 KRUSE WAY PL STE 300Lake Oswego, OR 97035-2479
Mailing AddressPo Box 3158Portland, OR 97208-3158 · (503) 215-6494
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateMay 7, 2018
Last NPPES UpdateFebruary 2, 2024
NPPES CertifiedFebruary 2, 2024
NPI 1548759418 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License Licensed in OR · 3693
Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

4004 KRUSE WAY PL STE 300, Lake Oswego, OR 97035

Accepted Insurance

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

Christopher Blaine Mikulic Psyd 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 ID4880042910
PECOS Enrollment IDI20231129002115
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 97035 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
$176.88 typical visit price
range $58.99 – $176.88
Typical copayment $44.22 (range $14.74 – $44.22)
Most-billed visit code 99205
Established Patient
$103.51 typical visit price
range $19.32 – $144.79
Typical copayment $25.87 (range $4.83 – $36.19)
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.

Physical Therapist
4004 KRUSE WAY PL STE 300
LAKE OSWEGO, OR 97035
Physical Therapist
4004 KRUSE WAY PL STE 300
LAKE OSWEGO, OR 97035
Nurse Practitioner (Family)
4004 KRUSE WAY PL STE 300
LAKE OSWEGO, OR 97035
Physical Therapist
4004 KRUSE WAY PL STE 300
LAKE OSWEGO, OR 97035
Internal Medicine
4004 KRUSE WAY PL STE 300
LAKE OSWEGO, OR 97035
Physical Therapist
4004 KRUSE WAY PL STE 300
LAKE OSWEGO, OR 97035
Family Medicine
4004 KRUSE WAY PL STE 300
LAKE OSWEGO, OR 97035
Internal Medicine
4004 KRUSE WAY PL STE 300
LAKE OSWEGO, OR 97035

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1548759418, enumerated as an "individual" on May 07, 2018.

The provider is located at 4004 KRUSE WAY PL STE 300 LAKE OSWEGO, OR 97035 and the phone number is (503) 216-1500.

Psychologist with taxonomy code 103TC0700X and a focus in Clinical.

The provider might be accepting Accepts: BridgeSpan Health Company, Providence Health Plan. Please consult your insurance carrier or call the provider to verify.