Individual provider Active NPI

Michelle Burke Noelck, MD

  • Pediatrics Physician
  • Portland, OR
National Provider Identifier
1487897138
Registry record updated Aug 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD157646 Issued in OR
Practice address
3181 SW Sam Jackson Park Road
Portland, OR 97239
Phone
(503) 494-8311
NPI assigned
Apr 10, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD157646 OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Road
Portland, OR 97239

Mailing address

4256 SW Corbett Ave
Portland, OR 97239-4259
Phone (520) 979-0033

Other names 1

  • Michelle Catherine Burke Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120522001042 OR Practitioner - Pediatric Medicine 4183887557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Arizona College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8311

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Jul 19, 2017 Accepting new patients
Oregon Health & Science University Past Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

Interoperability endpoints

  • Direct secure messaging: mnoelckmd16398@direct.ohsu.edu

Organizations & group practices 3

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": "1239321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377734400000",
    "number": "1487897138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4256 SW CORBETT AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394259",
            "telephone_number": "520-979-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK ROAD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97239",
            "telephone_number": "503-494-8311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOELCK",
        "first_name": "MICHELLE",
        "middle_name": "BURKE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-10",
        "last_updated": "2013-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD157646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "BURKE",
            "middle_name": "CATHERINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.