Individual provider Active NPI

Rex Z Nilson, DPM

  • Foot & Ankle Surgery Podiatrist
  • Edmonds, WA
National Provider Identifier
1386744324
Registry record updated Jun 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO00000340 Issued in WA
Practice address
7320 216TH St SW Ste 320B
Edmonds, WA 98026
Phone
(425) 775-6996
Fax
(425) 670-8905
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X PO00000340 WA Primary
Podiatrist 213E00000X PO0000034O WA

Addresses

Primary practice location

7320 216TH St SW Ste 320B
Edmonds, WA 98026

Mailing address

7320 216TH St SW Ste 320
Edmonds, WA 98026-8006
Phone (425) 673-3900

Other practice location 1

7315 212 st sw
suite 103
edmons, WA 98026
Phone (425) 775-6996

Other identifiers 4

IdentifierTypeStateIssuer
1004092MedicaidWA
81436OtherWAL&I
1009272MedicaidWA
PO0000034OOtherWASTATE LICENSE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070612000650 WA Practitioner - Podiatry 4082712286 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1983
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)

7320 216TH St SW
Suite 320
Edmonds, WA 98026-8006
Phone (425) 673-3900

Hospital & facility affiliations

  • Swedish Edmonds Hospital Hospital, Edmonds, WA, CCN 500026

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue74
Removal of skin lesions1-10
Removal of nail tissue423
Removal or shaving of skin growth357
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO0000034OWAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc P S CurrentSince Jun 25, 2018 Accepting new patients
Proliance Surgeons Inc P S Current Accepting new patients
Proliance Surgeons, Inc., P.S. CurrentSince Jun 25, 2018 Accepting new patients
Proliance Surgeons, Inc., P.S. Past Accepting new patients

Locations

7320 216th St SW
Ste 320
Edmonds, WA 98026
Phone (425) 673-3900

7320 216th St SW
Ste 320B
Edmonds, WA 98026
Phone (425) 775-6996

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

Interoperability endpoints

  • Direct secure messaging: rex.nilson.p131@direct.proliance.nextgenshare.com
  • Direct secure messaging: rex.nilson.p25@direct.proliance.nextgenshare.com
  • Direct secure messaging: rex.nilson.p24@direct.proliance.nextgenshare.com

Organizations & group practices 4

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 2

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528848000000",
    "number": "1386744324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7320 216TH ST SW STE 320",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268006",
            "telephone_number": "425-673-3900",
            "fax_number": "425-673-3910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7320 216TH ST SW STE 320B",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "98026",
            "telephone_number": "425-775-6996",
            "fax_number": "425-670-8905"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7315 212 st sw",
            "address_2": "suite 103",
            "address_purpose": "LOCATION",
            "city": "edmons",
            "state": "WA",
            "postal_code": "98026",
            "country_code": "US",
            "telephone_number": "425-775-6996",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NILSON",
        "first_name": "REX",
        "middle_name": "Z",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2018-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WA",
            "license": "PO00000340",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WA",
            "license": "PO0000034O",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1004092",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "81436",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1009272",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PO0000034O",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

Verify at the official NPI Registry.