Individual provider Active NPI

Amber Tandeske, ANP

  • Psychiatric/Mental Health Nurse Practitioner
  • Eagle River, AK
National Provider Identifier
1558529008
Registry record updated Jul 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NURU1444 Issued in AK
Practice address
11470 Business Blvd Ste 100
Eagle River, AK 99577-7780
Phone
(907) 689-3450
NPI assigned
May 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2021

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 NURU1444 AK Primary

Addresses

Primary practice location

11470 Business Blvd Ste 100
Eagle River, AK 99577-7780

Mailing address

PO Box 4105
Portland, OR 97208-4105
Phone (907) 212-6531

Other practice location 1

3760 Piper St
Suite Ll139
Anchorage, AK 99508-4683
Phone (907) 212-6233

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20150507001009 AK Practitioner - Nurse Practitioner 3274852504 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mat Su Valley Medical Center LLCGroup PAC ID 5698686475, 23 clinicians

Practice addresses (Care Compare)

2500 S Woodworth Loop
Palmer, AK 99645-8984
Phone (907) 861-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.18 of 100Reported as apm
Quality
71.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NURU1444AKMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mat Su Valley Medical Center LLC Current Accepting new patients
Advanced Telepsychiatry of Alaska LLC Current Accepting new patients
Mat-Su Valley III LLC Current Accepting new patients
Counseling Solutions of Alaska LLC Psychiatric/Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Mat-Su Valley Medical Center LLC CurrentSince Jul 27, 2021 Accepting new patients
Mat-Su Valley III LLC CurrentSince Nov 18, 2024 Accepting new patients

Locations

11470 Business Blvd
Ste 100
Eagle River, AK 99577
Phone (907) 622-4325

2480 S Woodworth Loop
Ste 285
Palmer, AK 99645
Phone (907) 861-6035

2500 S Woodworth Loop
Palmer, AK 99645
Phone (907) 861-6000

950 E Bogard Rd
Ste 207
Wasilla, AK 99654
Phone (907) 357-9444

950 E Bogard Rd
Wasilla, AK 99654
Phone (907) 352-2880

Interoperability endpoints

  • Direct secure messaging: amber.tandeske.1@2839.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1558529008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4105",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084105",
            "telephone_number": "907-212-6531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11470 BUSINESS BLVD STE 100",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777780",
            "telephone_number": "907-689-3450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3760 Piper St",
            "address_2": "SUITE LL139",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995084683",
            "country_code": "US",
            "telephone_number": "907-212-6233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANDESKE",
        "first_name": "AMBER",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-30",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AK",
            "license": "NURU1444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle River, AK

Sources for this page

Verify at the official NPI Registry.