Adam Mizgajski, MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

MD25223 Issued in OR

Practice address

9205 SW Barnes Rd
Portland, OR 97225-6603

Phone

(503) 216-2906

Fax

(503) 216-7106

NPI assigned

Jun 25, 2006

Last updated

Jul 27, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

HospitalistAlso: Internal Medicine

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Providence Health and Services - OregonGroup PAC ID 9335057447, 212 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Providence Health & Services - Oregon

  dba Providence St Vincent Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1114015971

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Providence Health & Services Oregon

  dba Providence Medical Group

  • General Practice Physician
  • Lake Oswego, OR
  • NPI 1023488343
  Medicare reassignment Care Compare group NPD
• Providence Health & Services Oregon

  dba Providence Hood River Memorial Hospital

  • Clinical Pathology Physician
  • Hood River, OR
  • NPI 1053862714

  Internal Medicine

  Medicare reassignment NPD
• Providence Health & Services Oregon

  dba Providence Seaside Hospital

  • Critical Access Hospital
  • Seaside, OR
  • NPI 1578500492
  Medicare reassignment NPD
• Providence Health & Services - Oregon

  dba Providence Medical Group

  • Neurology Physician
  • Portland, OR
  • NPI 1699804336
  NPD
• Providence Health & Services - Oregon

  dba Prov St. Vincent Medical Ctr

  • Clinical Pathology Physician
  • Portland, OR
  • NPI 1831641745

  Internal Medicine

  NPD
• Providence Health & Services Oregon

  dba Providence Hood River Memorial Hospital - Rural Health Clinic

  • Rural Health Clinic/Center
  • Hood River, OR
  • NPI 1073100095
  NPD
• Providence Health & Services Oregon

  dba Providence Medical Group

  • Psychiatry Physician
  • Portland, OR
  • NPI 1760177737
  NPD
• Providence Health & Services Oregon

  dba Providence Seaside Hospital - Providence Warrenton Clinic

  • Rural Health Clinic/Center
  • Warrenton, OR
  • NPI 1972039170
  NPD

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

• Providence Health & Services - Oregon

  dba Providence St Vincent Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1114015971
  Care Compare affiliation

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1861428278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9205 SW BARNES RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256603",
            "telephone_number": "503-216-2906",
            "fax_number": "503-216-7106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZGAJSKI",
        "first_name": "ADAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-25",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD25223",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OR",
            "license": "MD25223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "233191",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00451458",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tarryn Miyamura
• Alyson Miyose, P.T.
• Arissara Miyoshi, LPC
• Andrea Lynn Mize, L.C.S.W.
• Catherine Mizell, REGISTERED NURSE
• Colin Matthew Mizuo, DPM
• Aoi N Mizushima, MD
• Mja Health Services, Inc. (Hillsdale Chiropractic)
• ML Blettel MD
• MLB Nutrition & Wellness, LLC

• Hospitalist Physician in Portland, OR
• Providers in Portland, OR by specialty
• Hospitalist Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.