Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Amanda Marie Ilag, AGNP

Individual provider Primary Care Nurse Practitioner · NPI 1114745783

Amanda Marie Ilag, AGNP is a Nurse Practitioner in Berkeley, California. Qualified in 2024, 2 years ago. Practices with Pine Park Health, Inc, a 23-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
2
Licensed in
CA
In the registry since
2024
What do these letters mean?
AGNP — Adult-Gerontology Nurse Practitioner
A nurse practitioner focused on adults and older people.

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Practice location Address checks out

1901 4th St Ste 201
Berkeley, CA 94710-1986
Phone: (510) 929-1400
Fax: (510) 929-1414
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X · Licence 95032119 (CA)

Record details

NPI number1114745783
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGNP
Sole proprietorYes
NPI enumeratedOctober 1, 2024
Last updated in NPPESJanuary 16, 2025
Certification dateJanuary 15, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Pine Park Health, Inc — 23 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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