Individual provider Active NPI

Amanda C. Gerace, ARNP

  • Family Nurse Practitioner
  • Port Orchard, WA
National Provider Identifier
1114731122
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61658113 Issued in WA
Practice address
2407 Parkwood Dr SE
Port Orchard, WA 98366-2834
Phone
(757) 751-2026
NPI assigned
Feb 3, 2025
Last updated
Feb 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP61658113 WA Primary

Addresses

Primary practice location

2407 Parkwood Dr SE
Port Orchard, WA 98366-2834

Mailing address

2407 Parkwood Dr SE
Port Orchard, WA 98366-2834
Phone (757) 751-2026

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20250617003176 WA Practitioner - Nurse Practitioner 3072024942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eppel Family Medicine LLCGroup PAC ID 3870748122, 6 clinicians

Practice addresses (Care Compare)

1950 Pottery Ave
Suite 140
Port Orchard, WA 98366-2593
Phone (360) 876-5440

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP61658113WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eppel Family Medicine LLC CurrentSince May 25, 2025 Accepting new patients

Locations

1950 Pottery Ave
Ste 140
Port Orchard, WA 98366
Phone (360) 451-1600

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1738540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1114731122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2407 PARKWOOD DR SE",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983662834",
            "telephone_number": "757-751-2026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2407 PARKWOOD DR SE",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983662834",
            "telephone_number": "757-751-2026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERACE",
        "first_name": "AMANDA",
        "middle_name": "C.",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-03",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61658113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orchard, WA

Sources for this page

Verify at the official NPI Registry.