DEBORAH ELAINE MICKLEY – Certified Registered Nurse Anesthetist, NPI 1023364452

DEBORAH ELAINE MICKLEY is a healthcare provider. based in Minneapolis, Minnesota. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold a License No. R1697085 (MN). The NPI Number for DEBORAH ELAINE MICKLEY is 1023364452

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
DEBORAH ELAINE MICKLEY
NPI
1023364452
Phone
(612) 859-1656
Address
2828 CHICAGO AVE SOUTH
Enumeration Date
3 August 2012
Last Update Date
30 August 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6512627633
Graduation Year
2012 (14 years ago)
PAC ID
3072764984
Group Practice PAC ID
4587573613
Professional Enrollment ID
I20121126000558
Address ID
MN554071321MI2925XAVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience49
Completeness75
Years active:13State licenses:2Digital endpointsOther names

2,131 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in MN

Provider Addresses for DEBORAH ELAINE MICKLEY

  • 2828 CHICAGO AVE SOUTH

    SUITE 300

    MINNEAPOLIS, MN 55407

    Phone: (612) 859-1656

    Type: Mailing

  • 2250 NW 26th St

    Owatonna, MN 550605503

    Phone: (507) 451-3850

    Type: Location

  • 800 E 28th St

    Minneapolis, MN 554073799

    Phone: (612) 863-4000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-11-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20121126000558ICertified Registered Nurse Anesthetist (Crna)MNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55407)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4587573613View full group profile

Reviews

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Frequently asked questions

What unique ID ties claims to DEBORAH ELAINE MICKLEY?
NPI 1023364452 is assigned to DEBORAH ELAINE MICKLEY under the national enumeration system.
Is DEBORAH ELAINE MICKLEY's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does DEBORAH ELAINE MICKLEY list a primary specialty?
If you are matching referrals, note Certified Registered Nurse Anesthetist for DEBORAH ELAINE MICKLEY. Clinical services aligned with this taxonomy classification.
What location shows for DEBORAH ELAINE MICKLEY?
We surface Minneapolis, Minnesota for DEBORAH ELAINE MICKLEY based on available NPPES addresses.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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