Individual provider Active NPI

Robert Yost-Arch Amrine, MD

  • Sports Medicine (Family Medicine) Physician
  • Missoula, MT
National Provider Identifier
1366640484
Registry record updated Dec 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
12629 Issued in MT
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

Updated by the provider on Dec 2, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
807771700MedicaidID
1196275OtherIDMEDICARE 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
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective May 10, 2025 through May 10, 2027

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
69.83 of 100Reported as individual
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

LicenseStateTypeSpecialty
MR-0925IDMDFamily Medicine Physician
12629MTMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.