Individual provider Active NPI

Michael Mielniczek, CRNA

  • Certified Registered Nurse Anesthetist
  • Seattle, WA
National Provider Identifier
1013471663
Registry record updated Oct 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP61080711 Issued in WA
Practice address
1959 NE Pacific St
Seattle, WA 98195-5400
Phone
(206) 520-5000
NPI assigned
Jan 29, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP61080711 WA Primary

Addresses

Primary practice location

1959 NE Pacific St
Seattle, WA 98195-5400

Mailing address

PO Box 50095
Seattle, WA 98145-5095
Phone (206) 520-5700

Other identifiers 1

IdentifierTypeStateIssuer
1013471663MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201015001687 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5092053173 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Wa Anesthesia Services, PCGroup PAC ID 9335298884, 85 clinicians

Practice addresses (Care Compare)

1321 Colby Ave
Everett, WA 98201-1665
Phone (914) 491-9495

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
AP61080711WAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Center for Pain Management LLC Current Accepting new patients
Washington Center for Pain Management, LLC CurrentSince Nov 28, 2023 Accepting new patients
Washington Center for Pain Management LLC CurrentSince Nov 28, 2023 Accepting new patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 22, 2023 Accepting new patients
Providence Wa Anesthesia Services, P.C. CurrentSince Sep 15, 2021 Accepting new patients
Valley Regional Anesthesia Associates Inc CurrentSince Dec 3, 2023 Accepting new patients
Washington Center for Pain Management LLC CurrentSince Nov 28, 2023 Accepting new patients
Sports and Spine Past Accepting new patients

Locations

1900 116th Ave NE
Ste 201
Bellevue, WA 98004
Phone (425) 250-9999

1900 116th Ave NE
Ste 100
Bellevue, WA 98004
Phone (425) 753-3174

21600 Highway 99
Ste 260
Edmonds, WA 98026
Phone (425) 774-2650

1321 Colby Ave
Everett, WA 98201
Phone (425) 259-4413

11800 NE 128th St
Ste 100
Kirkland, WA 98034
Phone (425) 899-4500

501 N 34th St
Ste 101
Seattle, WA 98103
Phone (206) 838-1777

11027 Meridian Ave N
Ste 100
Seattle, WA 98133
Phone (206) 365-4492

1455 NW Leary Way
Ste 300
Seattle, WA 98107
Phone (206) 784-3350

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ACBEAD/Endpoint/ACBEAD

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1548720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1013471663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095",
            "telephone_number": "206-520-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981955400",
            "telephone_number": "206-520-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIELNICZEK",
        "first_name": "MICHAEL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-29",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP61080711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013471663",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.