Active NPI
Amanda R Flyckt, ARNP
- Nurse Practitioner
- Olympia, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- AP60520308
- Practice address
- 413 Lilly Rd NE
PMG SW Wa PSPH Hospitalists
Olympia, WA 98506-5133 - Phone
- (360) 493-4069
- NPI assigned
- Dec 12, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | AP60520308 | WA | Primary |
Addresses
Primary practice location
413 Lilly Rd NE
PMG SW Wa PSPH Hospitalists
Olympia, WA 98506-5133
Mailing address
PO Box 3360
Portland, OR 97208-3360
Other practice location 1
1717 S J St
Tacoma, WA 98405-4933
Phone (253) 426-6341
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2041629 | Medicaid | WA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | aflyckt481528@wm.providencedirect.org | Direct |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1717 S J St
Tacoma, WA 98405-4933
Phone (253) 426-6341
630 S Pearl St
Tacoma, WA 98465-2111
Phone (253) 671-7300
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP60520308 | WA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Franciscan Medical Group | Current | Accepting new patients | |
| Franciscan Medical Group | Current | Accepting new patients | |
| Washington Pac Services PC | Current | Accepting new patients | |
| Franciscan Medical Group | Current | Accepting new patients | |
| Wa Pacs 2 PC | Current | Accepting new patients | |
| Comprehensive Postacute Care PLLC | Current | Accepting new patients | |
| Alliance for South Sound Health | Current | Accepting new patients | |
| CS Pacs 3 Northwest, LLC | Current | Accepting new patients |
Locations
414 17th St SE
Auburn, WA 98002
Phone (253) 320-0748
21008 76th Ave W
Edmonds, WA 98026
Phone (425) 778-0107
135 S 336th St
Federal Way, WA 98003
Phone (253) 835-7433
34503 9th Ave S
Ste 130
Federal Way, WA 98003
Phone (253) 835-5340
920 12th Ave SE
Puyallup, WA 98372
Phone (253) 841-3422
3600 E Hartson Ave
Spokane, WA 99202
Phone (509) 468-7000
414 S University Rd
Spokane Valley, WA 99206
Phone (509) 924-4650
14820 E 4th Ave
Spokane Valley, WA 99216
Phone (509) 922-1644
1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200
3402 S 19th St
Tacoma, WA 98405
Phone (253) 301-5400
11315 Bridgeport Way SW
Tacoma, WA 98499
Phone (253) 588-1711
630 S Pearl St
Tacoma, WA 98465
Phone (253) 564-7111
1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101
Interoperability endpoints
- aflyckt481528@wm.providencedirect.org
Organizations & group practices 8
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.
-
- Hospitalist Physician
- Puyallup, WA
- NPI 1811752066
-
dba Franciscan Orthopedics-Silverdale
- Orthopaedic Surgery Physician
- Silverdale, WA
- NPI 1093165334
-
- Hospitalist Physician
- Spokane, WA
- NPI 1336678168
-
dba Wellfound Behavioral Health Hospital
- Psychiatric Hospital
- Tacoma, WA
- NPI 1891298980
-
- Internal Medicine Physician
- Tacoma, WA
- NPI 1023525698
-
- Hospitalist Physician
- Tacoma, WA
- NPI 1144706532
-
- Family Medicine Physician
- Tacoma, WA
- NPI 1366539421
-
dba The Doctors Clinic, A Part of the Franciscan Medical Group
- Internal Medicine Physician
- Silverdale, WA
- NPI 1710432612
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba St Joseph Lab PAC LAB
- Clinical Medical Laboratory
- Tacoma, WA
- NPI 1659585370
Hospital
-
dba St Joseph Medical Center
- General Acute Care Hospital
- Tacoma, WA
- NPI 1952309098
-
dba St Joseph Medical Center
- General Acute Care Hospital
- Tacoma, WA
- NPI 1124291117
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653264000000",
"number": "1386912897",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3360",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "413 LILLY RD NE",
"address_2": "PMG SW WA PSPH HOSPITALISTS",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985065133",
"telephone_number": "360-493-4069"
}
],
"practiceLocations": [
{
"address_1": "1717 S J St",
"address_purpose": "LOCATION",
"city": "Tacoma",
"state": "WA",
"postal_code": "984054933",
"country_code": "US",
"telephone_number": "253-426-6341",
"fax_number": "253-426-6344",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FLYCKT",
"first_name": "AMANDA",
"middle_name": "R",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-12",
"last_updated": "2022-05-23",
"certification_date": "2022-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WA",
"license": "AP60520308",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2041629",
"state": "WA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "aflyckt481528@wm.providencedirect.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "413 Lilly Rd NE",
"address_2": "PMG SW WA PSPH Hospitalists",
"city": "Olympia",
"state": "WA",
"country_code": "US",
"postal_code": "985065133",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.