Northwest Foot and Ankle Physicians and Surgeons, LLC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

P0725 Issued in WA

Legal business name

NORTHWEST FOOT AND ANKLE PHYSICIANS AND SURGEONS, LLC

Practice address

10821 19TH Ave SE
Everett, WA 98208-5103

Phone

(425) 337-7000

Fax

(425) 338-2408

NPI assigned

Oct 6, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Gordon Suichi Nishimoto, DPMNPI 1356334460

Title

President

Phone

(425) 337-7000

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gordon S Nishimoto, DPM

  • Foot & Ankle Surgery Podiatrist
  • Everett, WA
  • NPI 1356334460
  Medicare reassignment NPD Authorized official
• Trevor Gatenby, DPM

  • Foot & Ankle Surgery Podiatrist
  • Everett, WA
  • NPI 1649879347
  Medicare reassignment NPD
• Bryan Leonard Berghout, DPM

  • Foot & Ankle Surgery Podiatrist
  • Henderson, NV
  • NPI 1255411419

  WA

  Medicare reassignment NPD

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432166400000",
    "number": "1477640779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10821 19TH AVE SE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982085103",
            "telephone_number": "425-337-7000",
            "fax_number": "425-338-2408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10821 19TH AVE SE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982085103",
            "telephone_number": "425-337-7000",
            "fax_number": "425-338-2408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST FOOT AND ANKLE PHYSICIANS AND SURGEONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2015-05-21",
        "status": "A",
        "authorized_official_last_name": "NISHIMOTO",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "SUICHI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-337-7000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "WA",
            "license": "P0725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7138191",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northwest Ambulance LLC
• Northwest Ambulatory Surgery Center LLC
• Northwest Asthma & Allergy Center
• Northwest Cardiovascular Network
• Northwest Fishing Partner Registry
• Northwest Kidney Centers
• Northwest Natural Family Medicine, LLC
• Northwest Psychological Consulting, LLC
• Northwest Washington Eye Specialists
• Northwest Washington Radiation Oncology

• Podiatrist in Everett, WA
• Providers in Everett, WA by specialty
• Podiatrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.