Active NPI
Danielle Lynn Nack, DPM
- Podiatrist
- Mankato, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- E6129
- Practice address
- 1421 Premier Dr.
Mankato, MN 56001 - Phone
- (507) 625-1811
- NPI assigned
- May 27, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | E6129 | CA | Primary |
Addresses
Primary practice location
1421 Premier Dr.
Mankato, MN 56001
Mailing address
4468 Washington Blvd
Madison Lake, MN 56063-9670
Phone (507) 340-1128
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- Des Moines University of Osteopathic Medicine and Health Sciences, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4626 Willow Rd
Suite 200
Pleasanton, CA 94588-8564
Phone (925) 463-0470
Hospital & facility affiliations
- San Ramon Regional Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Lower limb (leg) arthroscopy (minimally invasive joint repair) | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E6129 | CA | MD | Podiatrist |
| 6129 | CA | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bass Medical Group | Current | Accepting new patients | |
| Bay Area Surgical Specialists Inc a Medical Corporation | Current | Accepting new patients | |
| Bass Medical Group | Podiatrist | Current | Accepting new patients |
| Bass Medical Group | Past | Accepting new patients | |
| Bass Medical Group | Past | Accepting new patients |
Locations
1505 Saint Alphonsus Way
Alamo, CA 94507
Phone (925) 837-4225
4626 Willow Rd
Ste 200
Pleasanton, CA 94588
Phone (925) 463-0470
Interoperability endpoints
- danielle.nack.1@25176.direct.athenahealth.com
Organizations & group practices 5
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.
-
- Orthopaedic Surgery Physician
- San Ramon, CA
- NPI 1467329904
-
- Clinical Medical Laboratory
- Walnut Creek, CA
- NPI 1265914956
-
- Specialist
- Walnut Creek, CA
- NPI 1154401941
-
- Pain Medicine Physician
- Visalia, CA
- NPI 1326409343
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- San Ramon, CA
- NPI 1932131489
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773964800000",
"number": "1083280358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4468 WASHINGTON BLVD",
"city": "MADISON LAKE",
"state": "MN",
"postal_code": "560639670",
"telephone_number": "507-340-1128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1421 PREMIER DR.",
"city": "MANKATO",
"state": "MN",
"postal_code": "56001",
"telephone_number": "507-625-1811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NACK",
"first_name": "DANIELLE",
"middle_name": "LYNN",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-27",
"last_updated": "2026-03-20",
"certification_date": "2026-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "CA",
"license": "E6129",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mankato, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.