Individual provider Active NPI

Amanda Jeanne Brender

  • Family Medicine Physician
  • Bellevue, WA
National Provider Identifier
1194040055
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60305649 Issued in WA
Practice address
13451 SE 36TH St
Bellevue, WA 98006-1475
Phone
(425) 562-1337
Fax
(425) 562-1331
NPI assigned
Apr 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD60305649 WA Primary

Addresses

Primary practice location

13451 SE 36TH St
Bellevue, WA 98006-1475

Mailing address

13451 SE 36TH St
Bellevue, WA 98006-1475
Phone (425) 562-1337

Other names 1

  • Amanda Jeanne Scannell Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync Health Information Exchange (HIE)

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140218001099 WA Practitioner - Family Practice 8729217641 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60305649WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vera Whole Health Wa PC CurrentSince Nov 1, 2022 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Nov 25, 2013 Accepting new patients
Vera Whole Health Wa PC CurrentSince Nov 1, 2022 Accepting new patients
Vera Whole Health Wa PC Current Accepting new patients
Kaiser Foundation Health Plan of Washington Family Medicine CurrentSince Nov 25, 2013 Accepting new patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients

Locations

100 W Towne Ridge Pkwy
Ste 200
Sandy, UT 84070
Phone (206) 395-6973

13451 SE 36th St
Bellevue, WA 98006
Phone (425) 562-1316

4933 Evergreen Way
Everett, WA 98203
Phone (425) 903-3070

13123 121st Way NE
Ste D
Kirkland, WA 98034
Phone (206) 470-1925

1201 2nd Ave
Ste 1400
Seattle, WA 98101

125 16th Ave E
#160
Seattle, WA 98112

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: amanda.brender.1@32512.direct.athenahealth.com
  • Direct secure messaging: abrender9223@ghc.direct-ci.net

Organizations & group practices 6

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": "1270425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1194040055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13451 SE 36TH ST",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980061475",
            "telephone_number": "425-562-1337",
            "fax_number": "425-562-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13451 SE 36TH ST",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980061475",
            "telephone_number": "425-562-1337",
            "fax_number": "425-562-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENDER",
        "first_name": "AMANDA",
        "middle_name": "JEANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-05",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60305649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "13451 SE 36th St",
            "city": "Bellevue",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980061475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "SCANNELL",
            "middle_name": "JEANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.