Individual provider Active NPI

Michael Thomas Vincent, CRNA

  • Certified Registered Nurse Anesthetist
  • Portland, OR
National Provider Identifier
1699335331
Registry record updated Feb 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
9161774 Issued in ID
Practice address
4805 NE Glisan St
Portland, OR 97213-2933
Phone
(503) 215-1111
NPI assigned
Jun 14, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Anesthesiology) Physician 207LC0200X 10023628 OR
Certified Registered Nurse Anesthetist 367500000X 9161774 ID Primary
Registered Nurse 163W00000X RN170524 AZ

Addresses

Primary practice location

4805 NE Glisan St
Portland, OR 97213-2933

Mailing address

4805 NE Glisan St
Portland, OR 97213-2933
Phone (503) 215-1111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, OR, ID3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20221103003326 AZ Practitioner - Certified Registered Nurse Anesthetist (Crna) 2860869872 Reassigns benefits to 2 organizations
I20240415002061 OR Practitioner - Certified Registered Nurse Anesthetist (Crna) 2860869872 Reassigns benefits to 1 organization
I20241205003382 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 2860869872 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of Arizona College of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Alphonsus Professional Medical Services LLCGroup PAC ID 7214849751, 124 clinicians
Anesthesia Associates of Coeur D Alene PLLCGroup PAC ID 2365427838, 58 clinicians

Practice addresses (Care Compare)

1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-2152

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051
Phone (208) 625-6400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.53 of 100Reported as group
Quality
78.73
Promoting interoperability
98
Improvement activities
40
Cost
62.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN170524AZMDRegistered Nurse
10023628ORMDCritical Care Medicine (Anesthesiology) Physician
9161774IDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
St Alphonsus Professional Medical Services LLC CurrentSince Oct 4, 2024 Accepting new patients
Banner - University Hospital Based Physicians LLC CurrentSince Jul 1, 2023 Accepting new patients
Hospitalist Medicine Physicians of Arizona - Nogales Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2022 Accepting new patients
Banner - University Hospital Based Physicians LLC CurrentSince Jul 1, 2023 Accepting new patients
Hospitalist Medicine Physicians of Washington - TCS Nurse Anesthetist, Certified Registered CurrentSince Mar 19, 2024 Accepting new patients
Anesthesia Associates of Coeur D Alene PLLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2026 Accepting new patients
Coronado Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2023 Accepting new patients
St Alphonsus Professional Medical Services LLC CurrentSince Oct 4, 2024 Accepting new patients
University of Arizona Nursing and Health Associates Past Accepting new patients

Locations

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

349 E Coronado Rd
Phoenix, AZ 85004
Phone (602) 266-5678

1601 W Saint Marys Rd
Tucson, AZ 85745
Phone (520) 622-5833

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

2003 Kootenai Health Way
Coeur D Alene, ID 83814
Phone (208) 625-5085

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

Organizations & group practices 9

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 2

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": "1560470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770768000000",
    "number": "1699335331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4805 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132933",
            "telephone_number": "503-215-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132933",
            "telephone_number": "503-215-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "MICHAEL",
        "middle_name": "THOMAS",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-14",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "OR",
            "license": "10023628",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "9161774",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN170524",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.