Active NPI
Michael Vincen-Brown, PA-C
- Physician Assistant
- Nampa, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA-1538
- Practice address
- 1115 12TH Ave
Nampa, ID 83686 - Phone
- (208) 498-1080
- Fax
- (208) 498-1081
- NPI assigned
- Oct 2, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA-1538 | ID | Primary |
Addresses
Primary practice location
1115 12TH Ave
Nampa, ID 83686
Mailing address
PO Box 191050
Boise, ID 83719-1050
Phone (208) 985-1399
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10482 W Carlton Bay Dr
Garden City, ID 83714-5143
Phone (208) 955-6500
11197 W Fairview Ave
Boise, ID 83713-7935
Phone (208) 378-8011
1375 N Happy Valley Rd
Nampa, ID 83687-5280
Phone (208) 809-2869
1474 N Meridian Rd
Kuna, ID 83634-2041
Phone (208) 809-2885
1475 N Cole Rd
Boise, ID 83704-8537
Phone (208) 809-2880
1900 W Chinden Blvd
Meridian, ID 83646-6690
Phone (208) 809-2860
260 S Ten Mile Rd
Meridian, ID 83642-6100
Phone (208) 809-2872
4971 W Overland Rd
Boise, ID 83705-2822
Phone (208) 472-5050
512 N 21St Ave
Caldwell, ID 83605-4368
Phone (208) 809-2875
6052 W State St
Boise, ID 83703-2739
Phone (208) 947-1947
8971 W Overland Rd
Boise, ID 83709-1651
Phone (208) 378-4288
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.87 of 100
- Quality
- 77.29
- Promoting interoperability
- 97
- Improvement activities
- 40
- Cost
- 74.78
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA-1538 | ID | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alliance Medical Group, LLC | Family Medicine | Current | Accepting new patients |
| Alliance Medical Group, LLC | Family Medicine | Current | Accepting new patients |
| Alliance Medical Group, LLC | Family Medicine | Past | Accepting new patients |
Locations
435 S Eagle Rd
Ste 100
Eagle, ID 83616
Phone (208) 609-9130
10482 W Carlton Bay Dr
Garden City, ID 83714
Phone (208) 454-9690
3115 E Florence Dr
Meridian, ID 83642
Phone (208) 378-4288
3280 E Lanark Dr
Meridian, ID 83642
Phone (208) 377-4400
1115 12th Ave Rd
Nampa, ID 83686
Phone (208) 498-1080
Interoperability endpoints
- michael.vincenbrown@phmg.eclinicaldirectplus.com
- https://fhir4.healow.com/fhir/r4/GJDCAA
- https://fhir4.healow.com/fhir/r4/GJDCAA/Endpoint/GJDCAA
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.
-
- Family Medicine Physician
- Garden City, ID
- NPI 1568413920
-
- Family Medicine Physician
- Boise, ID
- NPI 1487326203
-
- Family Medicine Physician
- Nampa, ID
- NPI 1851730949
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1506902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631059200000",
"number": "1003326398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 191050",
"city": "BOISE",
"state": "ID",
"postal_code": "837191050",
"telephone_number": "208-985-1399",
"fax_number": "208-985-6501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1115 12TH AVE",
"city": "NAMPA",
"state": "ID",
"postal_code": "83686",
"telephone_number": "208-498-1080",
"fax_number": "208-498-1081"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VINCEN-BROWN",
"first_name": "MICHAEL",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-10-02",
"last_updated": "2021-09-08",
"certification_date": "2021-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "ID",
"license": "PA-1538",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Nampa, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.