KYLIE VINCENT – Certified Registered Nurse Anesthetist, NPI 1245772953

KYLIE VINCENT is a healthcare provider. based in Saint louis park, Minnesota. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold a License No. 204856-5 (MN). The NPI Number for KYLIE VINCENT is 1245772953

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
KYLIE VINCENT
NPI
1245772953
Phone
(612) 275-9155
Address
3937 YOSEMITE AVE S
Enumeration Date
11 November 2016
Last Update Date
3 February 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7635593779
Graduation Year
2016 (10 years ago)
PAC ID
8820371248
Group Practice PAC ID
5698689123
Professional Enrollment ID
I20170209001699
Address ID
MN553871752WA500XXSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:9State licenses:1Digital endpointsOther names

2,131 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in MN

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Provider Addresses for KYLIE VINCENT

  • 3937, Yosemite Avenue South, Elmwood, Saint Louis Park, Hennepin County, Minnesota, 55416, United States

    SAINT LOUIS PARK, MN 554162821

    Phone: (612) 275-9155

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-02-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170209001699ICertified Registered Nurse Anesthetist (Crna)MNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55416)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5698689123View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)MN
Certified Registered Nurse Anesthetist (Crna)MN
Certified Registered Nurse Anesthetist (Crna)MN
Certified Registered Nurse Anesthetist (Crna)MN
-MN
-MN
-MN
-MN
A N E S T H E S I O L O G YMN
A N E S T H E S I O L O G YMN

Reviews

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Frequently asked questions

What is KYLIE VINCENT's NPI number?
KYLIE VINCENT's NPI is 1245772953 — the number used across U.S. healthcare to identify this provider.
Active or inactive — what applies to KYLIE VINCENT?
You should see KYLIE VINCENT as active in CMS-hosted NPPES data.
What clinical focus is listed for KYLIE VINCENT?
At a glance, KYLIE VINCENT is tied to Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for KYLIE VINCENT?
Travel planning: use Saint Louis Park, Minnesota as the reference point for KYLIE VINCENT, then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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