Individual provider Active NPI

Berlin Vincent

  • Certified Registered Nurse Anesthetist
  • La Jolla, CA
National Provider Identifier
1144987801
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
NA95001625 Issued in CA
Practice address
9500 Gilman Dr
La Jolla, CA 92093-5004
Phone
(760) 224-2952
NPI assigned
Nov 17, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NA95001625 CA Primary
Certified Registered Nurse Anesthetist 367500000X 96947501 NY

Addresses

Primary practice location

9500 Gilman Dr
La Jolla, CA 92093-5004

Mailing address

PO Box 232410
San Diego, CA 92193-2410

Other practice location 1

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (800) 926-8273

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220201002249 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6709279417 Reassigns benefits to 3 organizations
I20250217000936 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 6709279417 Reassigns benefits to 1 organization

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
Maple Gate Anesthesiologists, P.C.Group PAC ID 8022913839, 113 clinicians

Practice addresses (Care Compare)

818 Ellicott St
Buffalo, NY 14203-1021
Phone (716) 632-1088

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95001625CAMDFamily Nurse Practitioner
NA95001625CAMDCertified Registered Nurse Anesthetist
96947501NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Excelle Anesthesia Services, Inc. Anesthesiology CurrentSince Jun 20, 2023 Accepting new patients
Southern California Permanente Medical Group CurrentSince May 14, 2025 Accepting new patients
Maple Gate Anesthesiologists, P.C. Anesthesiology CurrentSince Jan 1, 2025 Accepting new patients
La Jolla Anesthesia Associates LP Nurse Anesthetist, Certified Registered CurrentSince May 21, 2024 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince May 14, 2025 Accepting new patients

Locations

2215 Truxtun Ave
Bakersfield, CA 93301
Phone (661) 477-9283

9850 Genesee Ave
Ste 980
La Jolla, CA 92037
Phone (858) 453-7525

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

818 Ellicott St
Buffalo, NY 14203
Phone (716) 323-2000

2568 Walden Ave
Ste 103
Cheektowaga, NY 14225

1540 Maple Rd
Williamsville, NY 14221
Phone (716) 568-3514

Organizations & group practices 6

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.

Hospital & facility affiliations 6

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": "1637107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774915200000",
    "number": "1144987801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 GILMAN DR",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920935004",
            "telephone_number": "760-224-2952"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 W Arbor Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921039000",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "BERLIN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-17",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "NA95001625",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "96947501",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2026; 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.