NPIMap

Individual provider Active NPI

Zachary Tyler Laidley, DPM

  • Podiatrist
  • Edmonds, WA
National Provider Identifier
1639668833
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO61309234 Issued in WA
Practice address
7320 216TH St SW Ste 320B
Edmonds, WA 98026-8006
Phone
(425) 775-6996
Fax
(425) 670-8905
NPI assigned
May 3, 2018
Last updated
Jul 13, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PO61309234 WA Primary
Foot & Ankle Surgery Podiatrist 213ES0103X PO61309234 WA

Addresses

Primary practice location

7320 216TH St SW Ste 320B
Edmonds, WA 98026-8006

Mailing address

7320 216TH St SW Ste 320
Edmonds, WA 98026-8006
Phone (425) 775-6996

Other identifiers 2

IdentifierTypeStateIssuer
2159301MedicaidWA
452640OtherWAWA LABOR & INDUSTRIES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220721003475 WA Practitioner - Podiatry 8123451531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2019
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 320B
Edmonds, WA 98026-8006
Phone (425) 775-6996

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue36
Removal or shaving of skin growth28
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc P S Current Accepting new patients
Proliance Surgeons Inc P S CurrentSince Jul 5, 2022 Accepting new patients
Proliance Surgeons Inc., P.S. CurrentSince Jul 5, 2022 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: zachary.laidley.p131@direct.proliance.nextgenshare.com
  • Direct secure messaging: zachary.laidley.p25@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1525305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1639668833",
    "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": "425-775-6996",
            "fax_number": "425-670-8905"
        },
        {
            "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": "980268006",
            "telephone_number": "425-775-6996",
            "fax_number": "425-670-8905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAIDLEY",
        "first_name": "ZACHARY",
        "middle_name": "TYLER",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-03",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WA",
            "license": "PO61309234",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WA",
            "license": "PO61309234",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2159301",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA LABOR & INDUSTRIES",
            "identifier": "452640",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

Verify at the official NPI Registry.