Individual provider Active NPI

Danielle Lynn Nack, DPM

  • Podiatrist
  • Mankato, MN
National Provider Identifier
1083280358
Registry record updated Mar 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E6129 Issued in CA
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

Updated by the provider on Mar 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250611002718 CA Practitioner - Podiatry 6709396310 Reassigns benefits to 1 organization

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
Bass Medical GroupGroup PAC ID 9032111281, 292 clinicians

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 Hospital, San Ramon, CA, CCN 050689

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E6129CAMDPodiatrist
6129CAMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bass Medical Group CurrentSince Aug 1, 2025 Accepting new patients
Bay Area Surgical Specialists Inc a Medical Corporation CurrentSince Aug 1, 2025 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

  • Direct secure messaging: 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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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

Verify at the official NPI Registry.