NICHOLAS ANDREW WILLIS – Registered Nurse, NPI 1609429125

NICHOLAS ANDREW WILLIS is a healthcare provider. based in Portland, Oregon. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold a License No. 201900742RN (OR). The NPI Number for NICHOLAS ANDREW WILLIS is 1609429125

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
NICHOLAS ANDREW WILLIS
NPI
1609429125
Phone
(360) 431-4408
Address
3455 SW US VETERANS HOSPITAL RD
Enumeration Date
23 July 2019
Last Update Date
23 July 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3603301870
Graduation Year
2022 (4 years ago)
PAC ID
5991187486
Group Practice PAC ID
5799853099
Professional Enrollment ID
I20220920002953
Address ID
WA985319073CE1900XRDXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:6State licenses:1Digital endpointsOther names

512 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in OR

Provider Addresses for NICHOLAS ANDREW WILLIS

  • 3455 SW US VETERANS HOSPITAL RD

    PORTLAND, OR 972393076

    Phone: (360) 431-4408

    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: 2022-09-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20220730000227ICertified Registered Nurse Anesthetist (Crna)ORTBD
I20220920002953ICertified Registered Nurse Anesthetist (Crna)WATBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
64450Injection of anesthetic agent and/or steroid into other nerve or branch2011$0
64447Injection of anesthetic agent and/or steroid into thigh nerve (femoral nerve)1717$0
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope1515$0
76942Ultrasonic guidance for needle placement1413$0
00811Anesthesia for other procedure on large bowel using an endoscope1111$0
View full utilization report →

Insurance plans in this area (ZIP 97239)

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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: 5799853099View full group profile
NameSpecialtyState
-WA
Certified Registered Nurse Anesthetist (Crna)CA
Certified Registered Nurse Anesthetist (Crna)GA
Certified Registered Nurse Anesthetist (Crna)FL
Certified Registered Nurse Anesthetist (Crna)WA
Certified Registered Nurse Anesthetist (Crna)WA
Certified Registered Nurse Anesthetist (Crna)MN
Certified Registered Nurse Anesthetist (Crna)WA
Certified Registered Nurse Anesthetist (Crna)MO
Certified Registered Nurse Anesthetist (Crna)TX

Reviews

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Frequently asked questions

What unique ID ties claims to NICHOLAS ANDREW WILLIS?
NPI 1609429125 is assigned to NICHOLAS ANDREW WILLIS under the national enumeration system.
Is NICHOLAS ANDREW WILLIS active in the national directory?
NICHOLAS ANDREW WILLIS's public NPI profile is in an active state.
What field does NICHOLAS ANDREW WILLIS work in?
You can think of NICHOLAS ANDREW WILLIS as practicing within Registered Nurse. Clinical services aligned with this taxonomy classification.
What location metadata exists for NICHOLAS ANDREW WILLIS?
The page summarizes Portland, Oregon for NICHOLAS ANDREW WILLIS; expand the address list for detail.
How can I contact NICHOLAS ANDREW WILLIS?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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