Individual provider Active NPI

Amy O. Zachara, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Kirkland, WA
National Provider Identifier
1124337969
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP60184986 Issued in WA
Practice address
10200 NE 132ND St
Kirkland, WA 98034-2831
Phone
(425) 821-2000
Fax
(425) 284-1727
NPI assigned
Sep 28, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP60184986 WA Primary

Addresses

Primary practice location

10200 NE 132ND St
Kirkland, WA 98034-2831

Mailing address

22722 29TH Dr SE Ste 100
Bothell, WA 98021-4420
Phone (425) 877-0683

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
I20101210000066 WA Practitioner - Nurse Practitioner 0446447882 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Neurostim TMS, PSGroup PAC ID 1557761608, 11 clinicians

Practice addresses (Care Compare)

9116 Gravelly Lake Dr SW
Suite 102
Lakewood, WA 98499-3148
Phone (253) 200-5763

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP60184986WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
BHC Fairfax Hospital Inc. CurrentSince Oct 10, 2010 Accepting new patients
Neurostim TMS, PS CurrentSince Apr 22, 2023 Accepting new patients
Neurostim TMS Minnesota PC PastSince Sep 8, 2024 Accepting new patients

Locations

1240 116th Ave NE
Ste 102
Bellevue, WA 98004
Phone (206) 250-9014

2200 Rimland Dr
Ste 115
Bellingham, WA 98226
Phone (360) 656-4250

125 130th St SE
Ste 204
Everett, WA 98208

10200 NE 132nd St
Kirkland, WA 98034
Phone (425) 821-2000

9116 Gravelly Lake Dr SW
Ste 102
Lakewood, WA 98499
Phone (253) 200-5763

10700 Meridian Ave N
Ste 406
Seattle, WA 98133
Phone (206) 620-1665

Interoperability endpoints

  • Direct secure messaging: neurostimtmscenters.amyzachara@152109.advancedmd-direct.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1285632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1124337969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22722 29TH DR SE STE 100",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980214420",
            "telephone_number": "425-877-0683",
            "fax_number": "425-790-0901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 NE 132ND ST",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980342831",
            "telephone_number": "425-821-2000",
            "fax_number": "425-284-1727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACHARA",
        "first_name": "AMY",
        "middle_name": "O.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-28",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60184986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.