Robert Montgomery

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2017010802 Issued in MO

Practice address

2861 Madison Ave
Granite City, IL 62040-3614

Phone

(618) 709-7723

NPI assigned

May 19, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Lincoln Memorial University Medical Department, 2016

Medicare assignment

May accept Medicare assignment

Group practices

Advanced Pain Relief Center LLCGroup PAC ID 0143605238, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

Practice roles

Locations

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.

• Advanced Pain Relief Center LLC

  • General Practice Physician
  • Saint Peters, MO
  • NPI 1467186411
  Medicare reassignment Care Compare group NPD
• Morningstar Neuropathy & Pain Treatment Center LLC

  • General Practice Physician
  • Saint Peters, MO
  • NPI 1073184248
  NPD (past)

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

{
    "created_epoch": "1495152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539734400000",
    "number": "1447787544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4221 HIGHWAY KK",
            "city": "NEW HAVEN",
            "state": "MO",
            "postal_code": "630682146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2861 MADISON AVE",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620403614",
            "telephone_number": "618-709-7723"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "621 S New Ballas Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631418232",
            "country_code": "US",
            "telephone_number": "314-567-5850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "ROBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-19",
        "last_updated": "2018-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2017010802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paulina Victoria Milanowski
• Daniel Jason Miller
• Terri Milton, LPC
• Elizabeth Patricia Mincy, APRN-C
• Mohammad R Ashraf MD
• Stacy Renae Moody, DMD
• Jillian L Moreno, HIS
• Emily Mouyard
• Roger Michael Mueller, D.M.D.
• Multi-Care Specialists SC

• Physician Assistant in Granite City, IL
• Providers in Granite City, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2018; 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.
• 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.