Amber Tario Gudas, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA60856995 Issued in WA

Practice address

1414 116TH Ave NE Ste E
Bellevue, WA 98004-3801

Phone

(425) 753-2918

Fax

(425) 328-1288

NPI assigned

Mar 26, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Amber Bethany Tario Former name

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Premier Dermatology, LLC

  • Dermatology Physician
  • Sarasota, FL
  • NPI 1700202298
  Medicare reassignment

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

{
    "created_epoch": "1332720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1174899017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3040 78TH AVE SE UNIT 958",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980403685",
            "telephone_number": "425-753-2918",
            "fax_number": "425-328-1288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 116TH AVE NE STE E",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043801",
            "telephone_number": "425-753-2918",
            "fax_number": "425-328-1288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUDAS",
        "first_name": "AMBER",
        "middle_name": "TARIO",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-26",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60856995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "TARIO",
            "middle_name": "BETHANY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Patricia Fallon Gruschow
• Mikhail Grushkovskiy, MT
• Yeabsera Gtsadik
• Jiangyan Gu, LMT
• Yueying Guan, OD
• Christopher Luke Guenther, D.C
• Mya Elizabeth Guerra, LMHCA
• Alexander Guerrero-Randall
• Carla Guerrero, P.T.
• Jennifer A Guidry, S.T.

• Physician Assistant in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.