GLEN MARTIN CUNNINGHAM FNP
NPI 1871450460
Nurse Practitioner - Family in Portland, OR

Q: What is Glen Cunningham's NPI number?

The NPI number for Glen Cunningham is 1871450460. It was assigned to this individual provider in the NPPES registry on January 6, 2026.

Q: What is Glen Cunningham's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Glen Cunningham was last updated on January 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 06, 2026PECOS EnrolledAccepts Medicare Assignment

2400 SW VERMONT ST, PORTLAND, OR 97219(503) 452-0915 Get Directions Write a Review

NPPES record last updated: January 6, 2026. Verified against the NPPES registry weekly; last sync: September 20, 2026.

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About Glen Martin Cunningham Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GLEN MARTIN CUNNINGHAM FNP (NPI 1871450460) is an individual family provider in Portland, Oregon, licensed in Oregon (10055208) and active in the NPI registry since January 2026. He is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1871450460

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameGLEN MARTIN CUNNINGHAMCredential: FNP

Location Address2400 SW VERMONT STPortland, OR 97219-1940

Mailing AddressPo Box 27Sublimity, OR 97385-0027 · (541) 602-0047

Phone(503) 452-0915

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateJanuary 6, 2026

NPPES CertifiedJanuary 6, 2026

✔ NPI 1871450460 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in OR · 10055208

2400 SW VERMONT ST, Portland, OR 97219

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Glen Martin Cunningham Fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3779486568

PECOS Enrollment IDI20260311002812

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97219 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$90.51 typical visit price

range $58.99 – $176.88

Typical copayment $22.62 (range $14.74 – $44.22)

Most-billed visit code 99203

Established Patient

$103.51 typical visit price

range $19.32 – $144.79

Typical copayment $25.87 (range $4.83 – $36.19)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SUSAN YEH MD

Internal Medicine