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Amanda Marie Ilag , AGNP

Nurse Practitioner - Primary Care β€’ Berkeley, CA

Active NPI 1114745783 Individual Practitioner Female Practitioner Accepts Medicare assignment Telehealth (some services)
Practice location in NPPES

1901 4th St Ste 201
Berkeley, CA 947101986

Call 5109291400 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1901 4th St Ste 201

Berkeley, CA 947101986

Telephone 5109291400
Fax 5109291414
Organization at the Same NPPES Address or Phone
Pine Park Health, Inc Facility NPI 1346879848

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

CMS Doctors and Clinicians lists 1 group name: Pine Park Health, Inc. See the list

Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Medicare Profile & Education

Source: CMS Doctors and Clinicians National Downloadable File

Graduation Year

2024

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2021–2025.

Guide: How to read an Open Payments record

Years since graduation

2 years (graduated 2024)

CMS Doctors and Clinicians data list 2024 as the year this clinician finished professional school.

What this does not show: Years since graduation

It is not the number of years in practice, and more years does not mean better care.

Source: CMS Doctors and Clinicians National Downloadable File.

NPI first issued

2024

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Accepts Medicare assignment

CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

Telehealth (some services)

Recent Medicare claims show this clinician provided some services by telehealth, such as a video or phone visit.

What this does not show: Telehealth (some services)

It does not mean all services are offered by telehealth, or that telehealth is covered by your plan.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Amanda Ilag has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Amanda Ilag as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Berkeley and California

10 active clinicians are listed under Nurse Practitioner - Primary Care with a practice address in Berkeley, CA (1,134 in California).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2025-01-15
Nurse Practitioner - Primary Care Primary Specialty

NUCC Taxonomy Code: 363LP2300X

License # reported to NPPES CA 95032119
Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Medical Board of California.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - NURSE PRACTITIONER

Medicare Enrollment ID

I20250128000862

Enrollment State Jurisdiction

CA

PECOS Control ID

5193254779

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Medicare Group Practice Enrollments

Source: CMS Doctors and Clinicians National Downloadable File

Pine Park Health, Inc

None, Berkeley, CA 94710

Phone: 5109291400

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

28 listed
Aminah Al-Saeedi , NP-C

Nurse Practitioner - Adult Health

NPI 1699016030

Nurse Practitioner (Certified)

Rebecca Armstrong , PA

Physician Assistant

NPI 1023765377

Physician Assistant

Harpreet Bal , AGACNP-BC

Nurse Practitioner - Gerontology

NPI 1760035976

Adult-Gerontology Acute Care Nurse Practitioner (Board Certified)

Jessica Behnam Hicks , FNP, RN

Nurse Practitioner - Family

NPI 1548620578

Family Nurse Practitioner, Registered Nurse

Kari Cedillo

Nurse Practitioner - Family

NPI 1386989630
Susan Choi , PA-C

Physician Assistant

NPI 1700323888

Physician Assistant (Certified)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

8 Historical Events
πŸ“
Updated Practice Location January 16, 2025

Registered at 1901 4TH ST STE 201, BERKELEY, CA 947101986 (Tel: 5109291400)

πŸ“
Updated Business Mailing Address January 16, 2025

Registered at PO BOX 511250, LOS ANGELES, CA 900517805 (Tel: 5109291400)

βœ…
NPI Profile Active October 01, 2024

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) October 01, 2024

Registered at 2130 POST ST APT 703, SAN FRANCISCO, CA 941153561 (Tel: 6304418437)

πŸ“
Business Mailing Address (Initial Record) October 01, 2024

Registered at 2130 POST ST APT 703, SAN FRANCISCO, CA 941153561 (Tel: 6304418437)

πŸ‘€
Provider Name / Credentials (Initial Record) October 01, 2024

Recorded as AMANDA ILAG, AGNP

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) October 01, 2024

Nurse Practitioner (license number reported to NPPES: CA 95032119)

🟒
Initial NPI Registration & Enumeration October 01, 2024

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1114745783
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 01, 2024
Last Update: January 16, 2025
Sole Proprietor: Yes

Other Nurse Practitioner - Primary Care Specialists in Berkeley

Healthcare providers in Berkeley

Mailing Address

Po Box 511250

Los Angeles, CA 900517805

Phone: 5109291400

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.