Individual provider Active NPI

Kylie Vincent

  • Certified Registered Nurse Anesthetist
  • St Louis Park, MN
National Provider Identifier
1245772953
Registry record updated Feb 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
204856-5 Issued in MN
Practice address
3937 Yosemite Ave S
Saint Louis Park, MN 55416-2821
Phone
(612) 275-9155
NPI assigned
Nov 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 204856-5 MN
Certified Registered Nurse Anesthetist 367500000X 204856-5 MN Primary

Addresses

Primary practice location

3937 Yosemite Ave S
Saint Louis Park, MN 55416-2821

Mailing address

3937 Yosemite Ave S
Saint Louis Park, MN 55416-2821
Phone (612) 275-9155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170209001699 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 8820371248 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Anesthesia Providers LLCGroup PAC ID 7315986064, 325 clinicians
Southdale Anesthesiologists LLCGroup PAC ID 6709842461, 62 clinicians
Metropolitan Anesthesia Network LLPGroup PAC ID 5698689123, 516 clinicians

Practice addresses (Care Compare)

2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone (612) 273-4097

4010 W 65TH St
Edina, MN 55435-1706
Phone (952) 924-5187

500 S Maple St
Waconia, MN 55387-1752
Phone (763) 559-3779

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
204856-5MNMDRegistered Nurse
2017MNMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Southdale Anesthesiologists, LLC CurrentSince Dec 18, 2023 Accepting new patients
Fairview Clinics CurrentSince May 26, 2020 Accepting new patients
Ridgeview Medical Center Nurse Anesthetist, Certified Registered Current Accepting new patients
Childrens Health Care CurrentSince Mar 1, 2025 Accepting new patients
Ridgeview Medical Center CurrentSince Nov 29, 2023 Accepting new patients
Childrens Health Care Current Accepting new patients
Fairview Clinics CurrentSince Mar 17, 2020 Accepting new patients
University Anesthesia Providers, LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 9, 2017 Accepting new patients
Childrens Health Care CurrentSince Mar 1, 2025 Accepting new patients
Healtheast Medical Research Institute CurrentSince May 26, 2020 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Ridgeview Medical Center CurrentSince Nov 29, 2023 Accepting new patients
Fairview Health Services Nurse Anesthetist, Certified Registered Current Accepting new patients
Healtheast Medical Research Institute CurrentSince May 26, 2020 Accepting new patients
Metropolitan Anesthesia Network, LLP Nurse Anesthetist, Certified Registered CurrentSince Nov 27, 2023 Accepting new patients
Fairview Health Services CurrentSince May 26, 2020 Accepting new patients
Fairview Clinics Current Accepting new patients

Locations

7907 Powers Blvd
Chanhassen, MN 55317
Phone (952) 934-0570

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

14500 99th Ave N
Ste 500
Maple Grove, MN 55369
Phone (763) 898-1400

4010 W 65th St
Minneapolis, MN 55435
Phone (952) 456-7000

2525 Chicago Ave
Minneapolis, MN 55404
Phone (612) 813-6000

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

2849 Johnson St NE
Minneapolis, MN 55418
Phone (612) 672-1900

4050 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 236-6786

14700 28th Ave N
Ste 20
Plymouth, MN 55447
Phone (612) 559-3779

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

5901 Lincoln Dr
#2
Saint Louis Park, MN 55436
Phone (952) 992-5691

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

500 S Maple St
Waconia, MN 55387
Phone (612) 442-2191

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 5

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": "1478822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486080000000",
    "number": "1245772953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3937 YOSEMITE AVE S",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "554162821",
            "telephone_number": "612-275-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3937 YOSEMITE AVE S",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "554162821",
            "telephone_number": "612-275-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "KYLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-11",
        "last_updated": "2017-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "204856-5",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "204856-5",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2017; 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.