Individual provider Active NPI

Robert Matt Cline, CRNA

  • Certified Registered Nurse Anesthetist
  • Tacoma, WA
National Provider Identifier
1346401833
Registry record updated Jan 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP60524188 Issued in WA
Practice address
3209S 23Rd St 340
Tacoma, WA 98405-1602
Phone
(253) 503-2598
Fax
(253) 404-0506
NPI assigned
Jun 18, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP60524188 WA Primary

Addresses

Primary practice location

3209S 23Rd St 340
Tacoma, WA 98405-1602

Mailing address

3209 S 23Rd St Ste 340
Tacoma, WA 98405-1602
Phone (253) 503-2598

Other identifiers 4

IdentifierTypeStateIssuer
8053236MedicaidNC
G8944391OtherWAMDCR PTAN (K)
G8960778OtherWAMDCR PTAN (P)
NAN849MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130214000315 WY Practitioner - Certified Registered Nurse Anesthetist (Crna) 4284706946 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Frontier Anesthesia LLCGroup PAC ID 6507147717, 4 clinicians

Practice addresses (Care Compare)

7220 Commons Cir
Cheyenne, WY 82009-2673
Phone (307) 635-4141

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Platte County Hospital Current Accepting new patients
Community Hospital Current Accepting new patients
Frontier Anesthesia LLC CurrentSince Dec 18, 2017 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Past Accepting new patients
Grand Anesthesiology Services PC Past Accepting new patients

Locations

7220 Commons Cir
Cheyenne, WY 82009
Phone (307) 635-4141

2000 Campbell Dr
Torrington, WY 82240
Phone (307) 532-4181

201 14th St
Wheatland, WY 82201
Phone (307) 322-3636

Organizations & group practices 5

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483574400000",
    "number": "1346401833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3209 S 23RD ST STE 340",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984051602",
            "telephone_number": "253-503-2598",
            "fax_number": "253-404-0506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3209S 23RD ST 340",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984051602",
            "telephone_number": "253-503-2598",
            "fax_number": "253-404-0506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINE",
        "first_name": "ROBERT",
        "middle_name": "MATT",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-18",
        "last_updated": "2017-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP60524188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8053236",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDCR PTAN (K)",
            "identifier": "G8944391",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDCR PTAN (P)",
            "identifier": "G8960778",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NAN849",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2017; 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.