Active NPI
Michael Angelo Tantay, CRNA
- Certified Registered Nurse Anesthetist
- Portland, OR
National Provider Identifier
1770727158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 201060008
- Practice address
- 125 NW 20TH Place
Unit No 511
Portland, OR 97209-1042 - Phone
- (714) 334-4787
- NPI assigned
- Apr 29, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 3851 | CA | |
| Certified Registered Nurse Anesthetist | 367500000X | 201060008 | OR | Primary |
Addresses
Primary practice location
125 NW 20TH Place
Unit No 511
Portland, OR 97209-1042
Mailing address
125 NW 20TH PL Unit No511
Portland, OR 97209-1042
Phone (714) 334-4787
Other practice location 1
11511 NE 10th St
Bellevue, WA 98004-8578
Phone (425) 502-3000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3851 | CA | MD | Certified Registered Nurse Anesthetist |
| 201060008 | OR | MD | Certified Registered Nurse Anesthetist |
Interoperability endpoints
- mtantay217596@ghc.direct-ci.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1240963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623283200000",
"number": "1770727158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 NW 20TH PL UNIT NO511",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972091042",
"telephone_number": "714-334-4787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 NW 20TH PLACE",
"address_2": "UNIT NO 511",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972091042",
"telephone_number": "714-334-4787"
}
],
"practiceLocations": [
{
"address_1": "11511 NE 10th St",
"address_purpose": "LOCATION",
"city": "Bellevue",
"state": "WA",
"postal_code": "980048578",
"country_code": "US",
"telephone_number": "425-502-3000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TANTAY",
"first_name": "MICHAEL",
"middle_name": "ANGELO",
"name_prefix": "Mr.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-04-29",
"last_updated": "2021-06-10",
"certification_date": "2021-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "CA",
"license": "3851",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "OR",
"license": "201060008",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "11511 NE 10th St",
"city": "Bellevue",
"state": "WA",
"country_code": "US",
"postal_code": "980048578",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Jun 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.