Active NPI
Robert Yost-Arch Amrine, MD
- Sports Medicine (Family Medicine) Physician
- Missoula, MT
National Provider Identifier
1366640484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Family Medicine) Physician
- License
- 12629
- Practice address
- 2360 Mullan Rd Ste C
Missoula, MT 59808-1811 - Phone
- (406) 721-4436
- Fax
- (406) 721-6053
- NPI assigned
- Jul 10, 2007
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MR-0925 | ID | |
| Family Medicine Physician | 207Q00000X | M-10516 | ID | |
| Sports Medicine (Family Medicine) Physician | 207QS0010X | 12629 | MT | Primary |
Addresses
Primary practice location
2360 Mullan Rd Ste C
Missoula, MT 59808-1811
Mailing address
2360 Mullan Rd
Ste C
Missoula, MT 59808-1811
Phone (208) 367-6042
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 807771700 | Medicaid | ID | |
| 1196275 | Other | ID | MEDICARE PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective May 10, 2025 through May 10, 2027
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 69.83 of 100
- Quality
- 44.49
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 54.96
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MR-0925 | ID | MD | Family Medicine Physician |
| 12629 | MT | MD | Sports Medicine (Family Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Lukes Regional Medical Center | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Boise, ID
- NPI 1770586794
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575244800000",
"number": "1366640484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2360 MULLAN RD",
"address_2": "STE C",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598081811",
"telephone_number": "208-367-6042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2360 MULLAN RD STE C",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598081811",
"telephone_number": "406-721-4436",
"fax_number": "406-721-6053"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMRINE",
"first_name": "ROBERT",
"middle_name": "YOST-ARCH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-10",
"last_updated": "2019-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ID",
"license": "MR-0925",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ID",
"license": "M-10516",
"primary": false
},
{
"code": "207QS0010X",
"taxonomy_group": "",
"desc": "Family Medicine, Sports Medicine",
"state": "MT",
"license": "12629",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "807771700",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "1196275",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Missoula, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- 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.