Individual provider Active NPI

Amanda Hudak, ARNP

  • Adult Health Nurse Practitioner
  • University Place, WA
National Provider Identifier
1669922480
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP60702234 Issued in WA
Practice address
2901 Bridgeport Way W
University Place, WA 98466-4614
Phone
(253) 534-7000
Fax
(253) 985-2853
NPI assigned
Oct 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X AP60702234 WA
Adult Health Nurse Practitioner 363LA2200X AP60702234 WA Primary

Addresses

Primary practice location

2901 Bridgeport Way W
University Place, WA 98466-4614

Mailing address

2901 Bridgeport Way W
University Place, WA 98466-4614
Phone (253) 534-7000

Other identifiers 1

IdentifierTypeStateIssuer
2104508MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ahudak213734@fhsce.catholichealth.net 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180813003185 WA Practitioner - Nurse Practitioner 2466700158 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

16251 Sylvester Rd SW
Burien, WA 98166-3017
Phone (206) 244-9970

1812 S J St
Suite 120
Tacoma, WA 98405-4965
Phone (253) 428-2200

Hospital & facility affiliations

  • Highline Medical Center Hospital, Burien, WA, CCN 500011

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP60702234WAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince Oct 1, 2020 Accepting new patients
Franciscan Medical Group CurrentSince Oct 1, 2020 Accepting new patients
Franciscan Health System Past Accepting new patients
Franciscan Health System Past Accepting new patients
Franciscan Health System Past Accepting new patients

Locations

34503 9th Ave S
Ste 130
Federal Way, WA 98003
Phone (253) 835-5340

1717 S J St
Fl 6
Tacoma, WA 98405
Phone (253) 426-6618

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

2901 Bridgeport Way W
University Place, WA 98466
Phone (253) 534-7000

Interoperability endpoints

  • Direct secure messaging: ahudak213734@fhsce.catholichealth.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 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": "1475539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1669922480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 BRIDGEPORT WAY W",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664614",
            "telephone_number": "253-534-7000",
            "fax_number": "253-985-2853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 BRIDGEPORT WAY W",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664614",
            "telephone_number": "253-534-7000",
            "fax_number": "253-985-2853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDAK",
        "first_name": "AMANDA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-04",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WA",
            "license": "AP60702234",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WA",
            "license": "AP60702234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2104508",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ahudak213734@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2901 Bridgeport Way W",
            "city": "University Place",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984664614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in University Place, WA

Sources for this page

Verify at the official NPI Registry.