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ROBERT W MONTGOMERY CRNA
NPI 1053680157
Nurse Anesthetist, Certified Registered in Portland, OR

Active since December 19, 2011Accepts Medicare Assignment
84.46/100
CMS Quality Rating
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239(503) 494-7641(503) 494-8368 Get Directions Write a Review

NPPES record last updated: February 7, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Robert W Montgomery Crna NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ROBERT W MONTGOMERY CRNA (NPI 1053680157) is an individual nurse anesthetist, certified registered in Portland, Oregon, licensed in Oregon (201402450CRNA) and active in the NPI registry since December 2011. He is affiliated with Providence Portland Medical Center and is a graduate of Other (2012).

NPPES Registry Identity

NPI1053680157
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameROBERT W MONTGOMERYCredential: CRNA
Location Address3181 SW SAM JACKSON PARK RDPortland, OR 97239-3011
Mailing Address3181 Sw Sam Jackson Park Rd # 2Portland, OR 97239-3011 · (503) 494-4910 · Fax (503) 494-8368
Phone(503) 494-7641
Fax(503) 494-8368
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateDecember 19, 2011
Last NPPES UpdateFebruary 7, 2020
✔ NPI 1053680157 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
Licenses✔ Licensed in OR · 201402450CRNA✔ Licensed in TN · 88013
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
Also ListedRegistered NurseTaxonomy 163W00000X · License RN167051 (TN)
3181 SW SAM JACKSON PARK RD, Portland, OR 97239
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Robert W Montgomery Crna is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4587826300
PECOS Enrollment IDI20140709003064

Medicare Billing Reassignments

2

Medicare enrollment records show Robert Montgomery reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Hospitalist Medicine Physicians Of Washington - Tcs
4.0 mi
Anesthesiology
4805 NE GLISAN ST
Portland, OR 97213
  • Reassigned Medicare billing, Oregon enrollment
  • 419 clinicians in this Medicare group
NPI 1649816380 (503) 215-1111
Tuality Anesthesia Services, LLC
14 mi
Anesthesiology
335 SE 8TH AVE
Hillsboro, OR 97123
  • Reassigned Medicare billing, Oregon enrollment
  • 48 clinicians in this Medicare group
NPI 1508174012 (503) 681-1690

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Providence Portland Medical Center

Acute Care Hospitals · Portland, OR
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number380061
Location4805 NE Glisan StreetPortland, OR 97213 · Multnomah County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97239 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$134.16 typical visit price
range $58.99 – $176.88
Typical copayment $33.54 (range $14.74 – $44.22)
Most-billed visit code 99204
Established Patient
$73.28 typical visit price
range $19.32 – $144.79
Typical copayment $18.32 (range $4.83 – $36.19)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

84.46/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality94.32
Improvement Activities40
Cost46.21

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DONALD RICHARD SULLIVAN MD
Internal Medicine (Pulmonary Disease)
3181 SW SAM JACKSON PARK RD, UHN67
PORTLAND, OR 97239
Multnomah County (503) 494-6949
MRS. ANJALEE NIX ROWE NP
Nurse Practitioner (Acute Care)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-3988
REEM HASAN MD
Internal Medicine
3181 SW SAM JACKSON PARK RD, PPV 350
PORTLAND, OR 97239
Multnomah County (503) 494-8562
DR. AMANDA D BALL PSY.D
Psychologist (Clinical)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-6176
SUNSHINE WELSCH LMT
Massage Therapist
3181 SW SAM JACKSON PARK RD, 7D19
PORTLAND, OR 97239
Multnomah County (503) 494-8349
DR. ROBERT GENE MEALER M.D., PH.D.
Psychiatry & Neurology (Psychiatry)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-6176
GREGORY HALL MD
Radiology (Diagnostic Radiology)
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 418-0990
DR. BURHAN AHMED MIAN MD
Student in an Organized Health Care Education/Training Program
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
Multnomah County (503) 494-8311

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Robert Montgomery's NPI number?

The NPI number for Robert Montgomery is 1053680157. It was assigned to this individual provider in the NPPES registry on December 19, 2011.

Where is Robert Montgomery located?

Robert Montgomery practices at 3181 SW Sam Jackson Park Rd, Portland, OR 97239. The listed phone number is (503) 494-7641.

What is Robert Montgomery's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Robert Montgomery enrolled in Medicare?

Yes. Robert Montgomery is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Robert Montgomery's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Robert Montgomery reassigns Medicare benefits to 2 organizations: Hospitalist Medicine Physicians Of Washington - Tcs (Portland, OR) and Tuality Anesthesia Services, LLC (Hillsboro, OR). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Robert Montgomery's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Robert Montgomery accept?

Health plans from Moda Health Plan, Inc. list Robert Montgomery as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Robert Montgomery affiliated with any hospitals?

According to CMS data, Robert Montgomery is affiliated with Providence Portland Medical Center.

When was this NPI record last updated?

The NPPES record for Robert Montgomery was last updated on February 7, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.