Individual provider Active NPI

Amanda Isula-Hillebert, FNP-BC

  • Family Nurse Practitioner
  • Tacoma, WA
National Provider Identifier
1891519930
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F354168-01 Issued in NY
Practice address
2215 N 30TH St
Suite 100
Tacoma, WA 98403-3350
Phone
(855) 871-0841
NPI assigned
Nov 14, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F354168-01 NY Primary

Addresses

Primary practice location

2215 N 30TH St
Suite 100
Tacoma, WA 98403-3350

Mailing address

2894 Gildersleeve Rd
Walworth, NY 14568-9704

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
I20250205003117 WA Practitioner - Nurse Practitioner 9335679315 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innovative Sleep Centers PLLCGroup PAC ID 6103010392, 5 clinicians

Practice addresses (Care Compare)

1123 S Market Blvd
Chehalis, WA 98532-3427
Phone (360) 807-4131

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F354168-01NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Medical Specialties PLLC CurrentSince Jan 27, 2025 Accepting new patients
Northwest Medical Specialties Pharmacy PastSince Jan 27, 2025 Accepting new patients

Locations

1624 S I St
Ste 102
Tacoma, WA 98405
Phone (253) 383-3366

1624 S I St
Ste 305
Tacoma, WA 98405

Interoperability endpoints

  • Direct secure messaging: amanda.isula-hillebert.1@17033.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1731542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1891519930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2894 GILDERSLEEVE RD",
            "city": "WALWORTH",
            "state": "NY",
            "postal_code": "145689704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 N 30TH ST",
            "address_2": "SUITE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984033350",
            "telephone_number": "855-871-0841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISULA-HILLEBERT",
        "first_name": "AMANDA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-14",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F354168-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.