Individual provider Active NPI

Amy B Van Cleave, NP

  • Family Nurse Practitioner
  • Missoula, MT
National Provider Identifier
1487376232
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
197670 Issued in MT
Practice address
2901 Brooks St
Missoula, MT 59801-7703
Phone
(406) 721-0918
Fax
(406) 829-7830
NPI assigned
Sep 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 197670 MT
Family Nurse Practitioner 363LF0000X 197670 MT Primary

Addresses

Primary practice location

2901 Brooks St
Missoula, MT 59801-7703

Mailing address

PO Box 7609
Missoula, MT 59807-7609
Phone (406) 721-5600

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address avancleave204621@wm.providencedirect.org Direct

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20221028002512 MT Practitioner - Nurse Practitioner 3173990488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Montana Clinic PCGroup PAC ID 2466365002, 44 clinicians

Practice addresses (Care Compare)

2901 Brooks St
Missoula, MT 59801-7703
Phone (406) 721-0918

Hospital & facility affiliations

  • St. Patrick Hospital Hospital, Missoula, MT, CCN 270014

Merit-based Incentive Payment System (MIPS)

Final score
82.1 of 100Reported as group
Quality
86.66
Promoting interoperability
77
Improvement activities
40
Cost
72.83

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
197670MTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Western Montana Clinic PC CurrentSince Nov 9, 2022 Accepting new patients
Western Montana Clinic PC Current Accepting new patients

Locations

500 W Broadway St
Missoula, MT 59802
Phone (406) 327-1918

2901 Brooks St
Missoula, MT 59801
Phone (406) 541-2886

Interoperability endpoints

  • Direct secure messaging: avancleave204621@wm.providencedirect.org

Organizations & group practices 2

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1663286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1487376232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7609",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598077609",
            "telephone_number": "406-721-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 BROOKS ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598017703",
            "telephone_number": "406-721-0918",
            "fax_number": "406-829-7830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN CLEAVE",
        "first_name": "AMY",
        "middle_name": "B",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-16",
        "last_updated": "2023-01-24",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MT",
            "license": "197670",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "197670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "avancleave204621@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2901 Brooks St",
            "city": "Missoula",
            "state": "MT",
            "country_code": "US",
            "postal_code": "598017703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.