Individual provider Active NPI

Amanda Marie Herges, PH.D.

  • Clinical Neuropsychologist
  • Seattle, WA
National Provider Identifier
1790917904
Registry record updated Sep 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
4338 Issued in AZ
Practice address
1600 S Columbian Way
VA Puget Sound
Seattle, WA 98108-1565
Phone
(320) 766-1655
NPI assigned
Aug 20, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 4338 AZ Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1600 S Columbian Way
VA Puget Sound
Seattle, WA 98108-1565

Mailing address

1600 S Columbian Way
VA Puget Sound
Seattle, WA 98108-1565
Phone (320) 766-1655

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150109002033 WA Practitioner - Clinical Psychologist 5890019327 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

12033 NE 130TH LN
Suite 120
Kirkland, WA 98034-3052
Phone (425) 899-2160

12039 NE 128TH St
Kirkland, WA 98034-3029

8980 161St Ave NE
Redmond, WA 98052-7554

Hospital & facility affiliations

  • Evergreenhealth Medical Center Hospital, Kirkland, WA, CCN 500124

Merit-based Incentive Payment System (MIPS)

Final score
86.73 of 100Reported as apm
Quality
73.46
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4338AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No 2 Current Accepting new patients
King County Public Hospital District No 2 Clinical Neuropsychologist CurrentSince Nov 5, 2014 Accepting new patients
King County Public Hospital District No. 2 CurrentSince Nov 5, 2014 Accepting new patients
King County Public Hospital District No 2 Past Accepting new patients

Locations

12039 NE 128th St
Ste 300
Kirkland, WA 98034
Phone (425) 899-3123

12040 NE 128th St
Ofc
Kirkland, WA 98034

8980 161st Ave NE
Ste 400
Redmond, WA 98052
Phone (425) 883-3404

Organizations & group practices 4

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": "1250726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378425600000",
    "number": "1790917904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 S COLUMBIAN WAY",
            "address_2": "VA PUGET SOUND",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981081565",
            "telephone_number": "320-766-1655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S COLUMBIAN WAY",
            "address_2": "VA PUGET SOUND",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981081565",
            "telephone_number": "320-766-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERGES",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-20",
        "last_updated": "2013-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "AZ",
            "license": "4338",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.