Individual provider Active NPI

Robert W Cruikshank, M.D.

  • Family Medicine Physician
  • Missoula, MT
National Provider Identifier
1700822483
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
63818 Issued in MT
Practice address
401 Railroad St W
Missoula, MT 59802
Phone
(406) 258-4789
Fax
(406) 258-4732
NPI assigned
Jun 21, 2006
Last updated
Jan 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 63818 MT Primary
General Practice Physician 208D00000X 63818 MT

Addresses

Primary practice location

401 Railroad St W
Missoula, MT 59802

Mailing address

401 Railroad St W
Missoula, MT 59802-4109
Phone (406) 258-4789

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181022001896 MT Practitioner - Family Practice 8527960855 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Partnership Health Center IncGroup PAC ID 6103843479, 51 clinicians

Practice addresses (Care Compare)

1150 Sherwood St
Missoula, MT 59802-2377
Phone 40625847894430

3050 Mt Hwy 83 N
Seeley Lake, MT 59868-8620
Phone (406) 677-2277

323 W Alder St
Missoula, MT 59802-4123
Phone (406) 258-4789

401 Railroad St W
Missoula, MT 59802-4178
Phone (406) 258-4789

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
63818MTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Partnership Health Center Inc. CurrentSince Aug 1, 2018 Accepting new patients
Partnership Health Center Inc Family Medicine Current Accepting new patients
Partnership Health Center Inc CurrentSince Aug 1, 2018 Accepting new patients

Locations

323 W Alder St
Missoula, MT 59802
Phone (406) 258-4195

401 Railroad St W
Missoula, MT 59802
Phone (406) 258-4183

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1700822483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 RAILROAD ST W",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024109",
            "telephone_number": "406-258-4789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 RAILROAD ST W",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "59802",
            "telephone_number": "406-258-4789",
            "fax_number": "406-258-4732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUIKSHANK",
        "first_name": "ROBERT",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "63818",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MT",
            "license": "63818",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.