Individual provider Active NPI

Michael Adam Sycko, RN

  • Registered Nurse
  • Shelby Township, MI
National Provider Identifier
1083384234
Registry record updated Sep 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704324932 Issued in MI
Practice address
54714 Blue Cloud Dr
Shelby Township, MI 48315-1230
Phone
(586) 786-5617
NPI assigned
Sep 19, 2021
Last updated
Sep 19, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704324932 MI Primary

Addresses

Primary practice location

54714 Blue Cloud Dr
Shelby Township, MI 48315-1230

Mailing address

54714 Blue Cloud Dr
Shelby Township, MI 48315-1230
Phone (586) 786-5617

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220307001379 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 8820482995 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Macomb Hospital CorporationGroup PAC ID 7911808381, shared by 5 NPIs, 349 clinicians

Practice addresses (Care Compare)

15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone (586) 263-2300

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Macomb Hospital Corporation CurrentSince Dec 5, 2023 Accepting new patients
Henry Ford Health Macomb Oakland Hospital CurrentSince Jan 15, 2022 Accepting new patients
Henry Ford Macomb Hospital Corporation CurrentSince Dec 5, 2023 Accepting new patients
Henry Ford Health Macomb-Oakland Hospital CurrentSince Jan 15, 2022 Accepting new patients
Henry Ford Health Macomb-Oakland Hospital CurrentSince Jan 15, 2022 Accepting new patients
Henry Ford Macomb Hospital Corporation CurrentSince Jul 1, 2025 Accepting new patients
Henry Ford Macomb Hospital Corporation Current Accepting new patients

Locations

7920 Solutions Ctr Dr
Chicago, IL 60677

7924 Solutions Ctr Dr
Chicago, IL 60677

30795 23 Mile Rd
Chesterfield, MI 48047
Phone (586) 421-3000

15717 15 Mile Rd
Clinton Twp, MI 48035
Phone (586) 285-3800

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

27351 Dequindre Rd
Madison Hts, MI 48071
Phone (248) 967-7000

11800 E 12 Mile Rd
Warren, MI 48093
Phone (586) 573-5000

Interoperability endpoints

  • Direct secure messaging: msycko538747@direct.hfhs.org

Organizations & group practices 7

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1632009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632009600000",
    "number": "1083384234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54714 BLUE CLOUD DR",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483151230",
            "telephone_number": "586-786-5617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54714 BLUE CLOUD DR",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483151230",
            "telephone_number": "586-786-5617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYCKO",
        "first_name": "MICHAEL",
        "middle_name": "ADAM",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-19",
        "last_updated": "2021-09-19",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704324932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2021; 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.