Gordon S Nishimoto, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

PO00000725 Issued in WA

Practice address

10821 19TH Ave SE Ste 201
Everett, WA 98208-5103

Phone

(425) 337-7000

Fax

(425) 338-2408

NPI assigned

Aug 24, 2005

Reactivated

Sep 18, 2006

Last updated

Mar 31, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Podiatry

Education

California School of Podiatric Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Proliance Surgeons Inc P SGroup PAC ID 8527972900, 395 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Regional Medical Center Everett Hospital, Everett, WA, CCN 500014

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gordon.nishimoto.p88@direct.proliance.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northwest Foot and Ankle Physicians and Surgeons, LLC

  • Podiatrist
  • Everett, WA
  • NPI 1477640779
  Medicare reassignment NPD Authorized official
• Proliance Surgeons Inc P S

  dba Proliance Surgeons Orthopedic Specialists of Seattle

  • Orthopaedic Surgery Physician
  • Seattle, WA
  • NPI 1023170313
  Medicare reassignment Care Compare group NPD
• Proliance Surgeons Inc P S

  dba Proliance Orthopedic Associates

  • Orthopaedic Surgery Physician
  • Renton, WA
  • NPI 1235091463
  NPD
• Proliance Surgeons, Inc., P.S.

  dba Proliance Retina

  • Ophthalmology Physician
  • Bellevue, WA
  • NPI 1841568946
  NPD
• Proliance Surgeons Inc., P.S.

  dba Orthopedic Physician Associates

  • Orthopaedic Surgery Physician
  • Seattle, WA
  • NPI 1558300434
  NPD (past)

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

• Providence Health & Services-Wa

  dba Providence Regional Medical Center Everett

  • Hospitalist Physician
  • Everett, WA
  • NPI 1649615220
  Care Compare affiliation
• Providence Health & Services-Wa

  • General Acute Care Hospital
  • Everett, WA
  • NPI 1700037801
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1356334460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 PACIFIC AVE STE 300",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014261",
            "telephone_number": "425-337-7000",
            "fax_number": "425-338-2488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10821 19TH AVE SE STE 201",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982085103",
            "telephone_number": "425-337-7000",
            "fax_number": "425-338-2408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISHIMOTO",
        "first_name": "GORDON",
        "middle_name": "S",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "deactivation_date": "2006-03-27",
        "reactivation_date": "2006-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WA",
            "license": "PO00000725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1036258",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tasha Uilani Nieves
• Anne Eileen Niggemeyer, PH.D.
• Manreet Nijjer
• Firoozeh Nikfarjam, OD
• Tammy Thanh Ninh, PHARMD
• Richard J. Nishman, M.D.
• Corina Nistor, MD
• Brian K. Nitta, OTR/L
• Odessa Marie Nix
• Bruce Frederick Nixon, DDS

• Foot & Ankle Surgery Podiatrist in Everett, WA
• Providers in Everett, WA by specialty
• Foot & Ankle Surgery Podiatrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; 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.

Verify at the official NPI Registry.