Amanda Marie Ilag, AGNP
NPI 1114745783ActiveIndividual· Nurse Practitioner, Primary Care· Berkeley, CA
Nurse Practitioner, Primary Care (AGNP) with Pine Park Health, Inc, practicing in Berkeley, California. Enrolled in Medicare as practitioner - nurse practitioner.
Overview
| NPI | 1114745783 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | AGNP |
| Sole proprietor | Yes |
| NPI issued | Oct 1, 2024 |
| Last updated in NPPES | Jan 16, 2025 |
| Certified by provider | Jan 15, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Primary Care Primary | 363LP2300X | 95032119 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Nurse Practitioner (CA) |
|---|
Education and affiliations
| Graduation year | 2024 |
|---|---|
| Medicare specialty | Nurse Practitioner |
| Telehealth | Offers telehealth |
Medical group
- Pine Park Health, IncBerkeley, CA · 22 clinicians
Other facilities
- Alliance Home HealthHome health agency · Daly City, CA
- Anx Home HealthcareHome health agency · Burlingame, CA
- Carelink Home Health Agency LLCHome health agency · Burlingame, CA
- Health Link Home Health AgencyHome health agency · San Francisco, CA
- Sutter Care at HomeHome health agency · San Mateo, CA
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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